Oral
Answers to
Questions

Environment, Food and Rural Affairs

The Secretary of State was asked—

Canal & River Trust Funding

Justin Madders: What recent discussions she has had with the Canal & River Trust on its funding.

Rebecca Pow: We have had many discussions with the Canal & River Trust over the past three years on the review of its funding, and we are providing it with more than £400 million of additional funding between 2027 and 2037. When the trust was created in 2012, the Department for Environment, Food and Rural Affairs and the trust signed a memorandum of understanding agreeing that the trust would have to move increasingly towards alternative sources of funding.

Justin Madders: In Ellesmere Port, we are proud that the Canal & River Trust has made its headquarters there, but we are concerned about the implications of the funding decisions, which amount to a £300 million cut in real terms over the next decade. Clearly that will cause the trust real problems, so I urge the Minister to think again about these decisions and to engage with the trust about how that gap can be bridged.

Rebecca Pow: We all recognise the important work and benefits that the Canal & River Trust brings, but the £300 million cut in funding asserted by the trust is not correct, because that includes adjustments for inflation. Government funding does not provide for that. We should also remember that an investment portfolio of over £1 billion was transferred to the trust, and it gets the benefits of the investments and the funding that accrues from them.

Lindsay Hoyle: I call the Member of “Rosie and Jim” fame.

Michael Fabricant: Thank you, Mr Speaker. As chairman of the all-party parliamentary group for the waterways, I share concerns about the future of our canal network, but I am conscious of the fact that 15 years ago when the trust was set up, the aim  was for it to be self-financing. Richard Parry, the chief executive, has discussed with me and Ministers in the past the possibility of receiving a lump sum, rather than a sum over 10 years. What progress has been made on that?

Rebecca Pow: I thank my hon. Friend for all the valuable work he does in that capacity. That subject is still under discussion.

American Bully XL

Neil Hudson: What discussions she has had with Cabinet colleagues on introducing the proposed ban on American Bully XL dogs.

Therese Coffey: The Prime Minister made a decision about introducing the proposed ban on American XL Bully dogs, recognising the horrific consequences of recent dog attacks and the disproportionate amount of those being undertaken by such dogs. We are working at pace on the legislation, and importantly on how it will be put into practice, and I hope to say more on that soon.

Neil Hudson: I thank the Secretary of State for her answer. As a veterinary surgeon, I strongly agree with the Prime Minister, the Home Secretary and the Secretary of State that we need to ban the dangerous American XL Bully dog as soon as possible to keep people and other animals safe. Does my right hon. Friend agree that in parallel to this necessary urgent action, we need to undertake important work with the public on responsible dog breeding, responsible dog ownership and better training and socialising of dogs as part of a holistic, long-term solution to dog attacks?

Therese Coffey: My hon. Friend has great credibility in this field, given his professional experience as a vet. I understand that many owners of XL Bully dogs are passionate about their animals—their pets. That is why we are working at pace, but taking our time to get right the definitions and the transition period that we anticipate. It is important that all dog owners work to make sure that their dogs behave and have appropriate training. That is why we established a taskforce that includes dog welfare charities. We expect it to respond to us by the end of the year, and we will potentially take forward some of its recommendations.

Jim Shannon: As someone who has had a pet dog all my life and still does, I am conscious that some of those who own American XL Bully dogs think that their dogs are integral and safe, but many in the general public see them as a danger and have fear. Is the Secretary of State’s intention, as this process goes forward in Westminster, to engage with the Northern Ireland Assembly and the police, in particular, to ensure that the law and the recommendations that come out of this place can be shared with them?

Therese Coffey: The hon. Gentleman is right to recognise owners’ concerns where they believe that they have very good dogs. That is to some extent accommodated already in the legislation that has evolved since 1991. On working  with other nations, the law—the primary legislation—will apply in both England and Wales by default, but we are working with the Scottish Government and the Northern Ireland Administration on potential moves to make this a UK-wide approach.

Lindsay Hoyle: I call the shadow Minister.

Ruth Jones: I listened carefully to the answers the Secretary of State gave to both hon. Members, but I am still not reassured that she has the planned legislation in place to ban XL Bully dogs effectively. Is she satisfied that we have the kennel space across the UK, enough vets to make assessments, and clear rules and legislation in place to make the ban effective?

Therese Coffey: The hon. Lady asks a fair question. The legislation has evolved since 1991, with amendments made to the primary legislation in 1997 and in the Dangerous Dogs Exemption Schemes (England and Wales) Order 2015. In that, there is a combination of work with the police in particular and with local councils and, of course, the judicial system. We have been working closely with my right hon. Friend the Minister for Crime, Policing and Fire to take the matter forward. I want to ensure that the legislation is right. I am expecting to present two statutory instruments to make it effective, with one bringing the ban into effect and the other providing the transition element and some of the finer details that still need to be completed.

Resources and Waste Strategy:  Extended Producer Responsibility

Alex Cunningham: Whether she plans to publish a new timeline for key milestones on (a) extended producer responsibility for packaging and (b) other measures in the 2018 resources and waste strategy for England.

Rebecca Pow: In July, we announced the deferral of the producer payments under the extended producer responsibility scheme, moving them to October 2025. I must say that that was at the request of industry, which asked for more time so that it could prepare. We remain fully committed to delivering the programme to the timeline. The Government continue to deliver obligations set out in the 2018 resources and waste strategy, and we recently published “Maximising Resources, Minimising Waste”, which is England’s waste prevention programme. On 1 October, we also expanded our ban on certain single-use plastic items.

Alex Cunningham: I am grateful for that comprehensive answer. No one should underestimate the critical role of recycling, but, as I am told by the Green Alliance, it is critical that it is economically viable for the industry, which is worried about the increased costs of waste separation in the Government’s proposals. I accept what the Minister said, but will she confirm whether her Department’s upcoming simpler recycling proposals  will retain commitments for recycling to be separated  at home?

Rebecca Pow: Details of the simpler recycling system will be announced shortly, but I can tell the House that it will mean that all local authorities will collect the same materials. Of course, as we have always said, food waste will have to be collected separately. It will also be flexible. This has all been discussed with local authorities.

Food System: Health and Sustainability

Kerry McCarthy: What steps she is taking to support a healthy and sustainable food system.

Mark Spencer: The Government’s food strategy set out longer-term measures to support a resilient, healthier and more sustainable food and farming system. In May, the Prime Minister’s farm to fork summit built on that with a focus on how we can work together to support a thriving UK food and farming industry. The summit focused on innovation, skills and labour, and on rolling out the new farming schemes to ensure fairness across the supply chain to boost exports and support energy and water security, as well as to reduce red tape.

Kerry McCarthy: Every year, post-farm gate, 9.5 million tonnes of food that could have provided more than 15 billion perfectly edible meals is wasted. That also has a massive carbon footprint. Given that DEFRA’s impact assessment concluded that mandatory food waste reporting would result in
“financial benefits to business and significant environmental benefits”
and is backed by many retailers, including Tesco, why have the Government dropped their plans?

Mark Spencer: We are working closely with retailers to try to reduce food waste and will continue to do that. The hon. Member will recognise that a vast amount of food waste occurs within the domestic home, and we can do more to help and support consumers to make the most of the food they purchase. We will continue to work with primary producers, retailers and consumers to reduce food waste wherever we can.

Desmond Swayne: Sustainability is top of our agenda in the New Forest, and the national park authority is keen to discuss opportunities for it with the Minister. I have sent him an invitation—will he come?

Mark Spencer: I am excited to have an opportunity to visit the New Forest. As soon as my diary allows, I will hot-foot it down there to meet my right hon. Friend.

Lindsay Hoyle: I call the shadow Minister.

Daniel Zeichner: To maintain that healthy, sustainable food system, farmers need a level playing field, so when the right hon. Member for North East Somerset (Sir Jacob Rees-Mogg) made his recent comments about the benefits of importing hormone-injected beef, it sent a shudder through the industry. This time last year, he was at the very top of Government, alongside the Secretary of State. Given the Minister’s long experience in Government, can he tell us how many others at the top of his Government privately harbour that view?

Mark Spencer: The gentleman at the top of Government —the Prime Minister—has been absolutely clear and explicit that we will not accept hormone-produced beef at any point in the future, nor will we accept chlorinated chicken. He has the backing and support of British farmers, and he will do everything he can to help and support them.

Water Companies: Water Pollution and Overflows

Tom Randall: What steps her Department is taking to require water companies to help reduce water pollution and unsatisfactory overflows.

Rebecca Pow: I am pleased that my hon. Friend has asked that question, because no Government in history have taken a more comprehensive approach to tackling water pollution. This Conservative Government are delivering more investment, stronger regulation and tougher enforcement to tackle every source of water pollution. Under our storm overflows discharge reduction plan, £60 billion is targeted at cleaning up storm sewage overflows. Thanks to our monitoring, we know what is happening and we are able to take action. Let me remind Members that there was virtually no monitoring under the Labour Government. This Government are setting the record straight.

Tom Randall: I am grateful to my hon. Friend for that answer. The Liberal Democrats pretend that we can fix storm overflows in 48 hours and Labour has an undeliverable sewage plan, so it is unsurprising that sewage is discharged more often in socialist-run Wales. Can my hon. Friend confirm that it is only the Conservatives’ plan for water that is credible, costed and comprehensive?

Rebecca Pow: As ever, my hon. Friend is right on the button. We are the only party with a costed, credible plan to tackle this issue, and we uncovered it. If Labour had a plan, it would be using it in Wales. We have just heard how serious the illegal sewage discharges are in Wales. We have discovered that not only has Natural Resources Wales not carried out any enforcement, but it has not issued any fines at all on this subject—nothing. And the Liberals do not have any plans.

Lindsay Hoyle: Order. We will get through these questions. I have to get to a certain number and I have not yet called the Chair of the Select Committee, and you are not helping me.

Chi Onwurah: Like many of my constituents, over the summer I took advantage of the relatively warm temperatures in the North sea to enjoy swimming off our coast. Should my constituents and I worry about the quality of the water due to the practices of water companies? Is it not time for Labour’s plan for automatic fines for discharges?

Rebecca Pow: Ninety three per cent of bathing water around our coast is good or excellent. It is a tremendous record.

Lindsay Hoyle: I call the Chair of the Environment, Food and Rural Affairs Committee.

Robert Goodwill: Scarborough’s South bay is included in the 7% of bathing water without a blue flag. North Yorkshire Council recently convened a taskforce of local politicians, the Environment Agency, Yorkshire Water and others, including academics from Durham University, to look at the problem. It became clear that it is not as simple as many people think. Discharges come from further north around the bay, and pathogens were picked up not only from human effluent but from sea birds, dogs and ruminants. Will the Minister take a personal interest in that work, because lessons learned in Scarborough may well apply around the country?

Rebecca Pow: My right hon. Friend highlights that the issue is not as simple as people think. That is why our plan for water takes a holistic approach to tackling all sources of water pollution. It is also why we launched our £34 million slurry fund to help farmers reduce the pollution that they may inadvertently put into watercourses.

Barry Sheerman: I have never heard such codswallop in all my time in the House. I was born by the Thames and I love the rivers, and I have to say to the Minister that I have seen no Government in history who have put more sewage into our streams, rivers and oceans than hers since the privatisation of water.

Rebecca Pow: I had a meeting about the Thames tideway tunnel yesterday. That amazing project has already increased wildlife so extraordinarily at the end by the Lee tunnel that there are kingfishers, otters and all kinds of other creatures there. When the tunnel is finished, it will be the biggest single means of cleaning up the Thames that has ever been put in place. It is this Government, through a special tool of private-public funding, who are enabling that.

Lindsay Hoyle: I call the shadow Secretary of State.

Steve Reed: Last year, this Government oversaw record levels of illegal sewage discharges into our rivers and waterways after they cut enforcement, and then they let the water bosses reward themselves for that failure with nearly £10 million in bonuses while hiking bills for consumers. Labour believes that the polluter, and not the consumer, should pay. Will the Government adopt Labour’s plan and give the regulator the power it needs to block water bosses’ bonuses if they keep illegally pumping toxic filth into our rivers?

Rebecca Pow: I have already said that Labour has not costed its plan, which has no credibility whatsoever. We have already changed regulation and the tools that Ofwat and the EA can use. No dividends or bonuses can be paid out at all if there is any environmental damage, and there are more fines than ever before. There were no fines under the Labour Government; indeed, they were taken to court by the European Commission for polluting water, and they did nothing about it. This Government introduced the monitoring, and that is why we know what is happening and why we have the biggest criminal investigation in the history of water under way.

Fishing Communities

Sally-Ann Hart: What steps she is taking to support fishing communities.

Mark Spencer: The Government are supporting communities by opening new fisheries for spurdog and bluefin tuna, accelerating action to protect valuable non-quota stocks through the first fisheries management plans, and protecting stocks by better controlling fly-seiners, and we have brought about increased benefit through reform of the economic link.

Sally-Ann Hart: Off the coast of beautiful Hastings and Rye, fishermen are suffering the impact on their fishing of a growing seal colony. Due to the nature of the fishing—small boats leave their nets in the water—sound systems to deter seals are not appropriate. What steps is the Minister taking to ensure that the presence of seals does not result in the decimation of our fishing communities, let alone the fish?

Mark Spencer: I pay tribute to my hon. Friend, who is a tenacious campaigner for her fishing community. We are working alongside the Marine Management Organisation to assess non-lethal seal deterrent options to keep seals away from fishing catches, and we will publish an evidenced report on targeted acoustic startle technology later this year. We are also considering the next steps, including for net fisheries, under our Clean Catch programme. The special committee on seals provides formal scientific advice to the Government on behalf of the Natural Environment Research Council on the management of seal populations under the Conservation of Seals Act 1970 and the Marine (Scotland) Act 2010. Its reports include seal population data based on extensive regional surveys and form the foundation for monitoring our UK marine strategy.

Alistair Carmichael: I wonder whether the Minister has seen the video footage that is doing the rounds of the recent incident involving the Spanish longliner Antonio Maria trying to ram the Shetland whitefish boat Defiant; in fact, it put out a rope to foul its propeller. The footage is truly shocking, but the real scandal is that this is not the first time it has happened; it is at least the third documented incident in recent times. This will keep happening unless something is done to stop it, so will the Minister speak to his colleagues in the Department for Transport and the Foreign Office to make sure that France, as the flag state with enforcement powers in this case, takes its responsibility seriously?

Mark Spencer: I have seen that footage. It is truly shocking. This was a deliberate act to try to sabotage a UK fishing boat. It was outrageous behaviour. As the right hon. Gentleman identifies, enforcement is difficult, because the incident involved a Spanish boat under a French flag, but given the seriousness of the event I will most certainly raise it with my ministerial colleagues.

Community Farming Projects

Christine Jardine: What steps her Department is taking to support community farming projects.

Mark Spencer: We welcome community farms in England, because they give local communities a chance to become involved in the countryside. Like any other farm, they may be eligible for a variety of grants enabling smaller farms to be supported more fairly. We have introduced a sustainable farming incentive management payment, and we have also extended the farming in protected landscapes fund until March 2025. The fund is open to farmers in national parks and areas of outstanding natural beauty, allowing them to deliver projects to support nature, climate, people and places.

Christine Jardine: Figures from a social return on investment study show that every £1 invested in a community farm is worth £9 of community benefits through food production, new skills and community resources. In my constituency, for instance, Lauriston Farm is investing in a community orchard and gardens, outdoor learning and a community kitchen to help people pick up new skills and produce affordable food. Does the Minister agree that in a cost of living crisis it is critically important for people to have access to such facilities, and that more needs to be done to help small community projects to maximise their potential?

Mark Spencer: I pay tribute to those who are involved in that community project. As the hon. Lady will know, agriculture is devolved to the Scottish Government, and I hope they will use some of the £620 million a year that they are given to support Scottish farmers. I am sure she will be a tenacious campaigner in holding the SNP Government to account.

Flood-risk Areas: Rural Communities

Daniel Kawczynski: What steps her Department is taking to protect rural communities in flood-risk areas.

Theo Clarke: What steps her Department is taking to protect rural communities in flood-risk areas.

Rebecca Pow: The Government’s six-year £5.2 billion flood investment programme benefits both urban and rural communities. Approximately 40% of schemes and 45% of investments are being directed at rural communities, which have benefited from our frequently flooded fund, our natural flood management fund and our flood and coastal innovation programmes.

Daniel Kawczynski: The Minister has visited Shrewsbury a number of times at my invitation, and has heard at first hand from the River Severn Partnership, which is trying to find a holistic solution to the problems of managing Britain’s longest river rather than just creating flood barriers which push the problem downstream. When can give us more information and an update on the resources being afforded to the partnership to support landowners and others who can be part of that solution?

Rebecca Pow: I thank my hon. Friend for the great work that he does with the partnership. Both the Secretary of State and I have visited his constituency. There are funds available: the £25 million for natural flood  management schemes may be of interest to farmers, and the environmental land management schemes include provisions for temporary storage capacity on farms.

Theo Clarke: In the autumn, storm overflows are inevitable, and my constituents are holding their breath as they wonder whether their homes will be flooded once again. I understand from speaking to residents that it is very unclear whom they should call when that occurs, so will the Minister look again at setting up a national flood line that can be called at any time, and ensure that it is connected to a local flood centre that will be accountable for a response from local services?

Rebecca Pow: I have visited my hon. Friend’s constituency, and I know that she has done a great deal of work on the issue of flooding. The Environment Agency works in partnership with the Met Office to provide an online “checking for flooding” service, which is operating today to deal with Storm Babet. Members of the public can check the flood risk, find advice and guidance on how to prepare for flooding, and sign up for warnings on the gov.uk site.

Lindsay Hoyle: I call the shadow Minister.

Emma Hardy: I listened carefully to the Minister’s response, and I noted that she did not mention the National Infrastructure Council’s report, commissioned by the Government a year ago, which stated that an extra 190,000 homes were at risk of flooding—not because of climate change, but because of the Government’s failure to maintain existing flood defence assets. When the Government cannot even get the basics right, how can anyone possibly trust them to have the answers to the ever-increasing flood risk that our country faces?

Rebecca Pow: That is exactly the Environment Agency’s duty, and it works very hard on the asset management side of our flood assets, which are a very large proportion of our £5.2 billion fund.

Sewage Discharges

Liz Twist: What assessment she has made of the adequacy of the steps taken by her Department to prevent sewage discharges.

Rebecca Pow: We have gone further and faster than any Government in history to drive down sewage discharges. Last month we published our £60 billion plan, which sets stringent targets to reduce sewage discharges. Those targets will prioritise action at target sites. What did Labour do? It did nothing when it was in power.

Liz Twist: Water companies need stable finances to make improvements. In December 2022, Ofwat outlined concerns about the financial resilience of several water companies. What has the Minister done to mitigate the risks, and what will she be doing in future?

Rebecca Pow: The Ofwat report on sewage discharges, published in September, was extremely disappointing. I have written to all the water companies that were highlighted as lagging, and I have written to all the  CEOs to say that I want to meet them in person. I have also written to the CEO and chair of Ofwat to ask how they will hold these water companies to account.

Cherilyn Mackrory: This Government introduced monitoring, so we now know the state of the problem. The water companies are now engaging and Ofwat has powers to put financial pressure on them. Given that only 4% of sewage overflows in Scotland are monitored, does this not show that we are progressing it in the right way and that the nationalisation of water companies is not the way to go?

Rebecca Pow: I agree with my hon. Friend.

Food Affordability and Inflation

Hannah Bardell: What recent assessment she has made of the impact of inflation on the affordability of food.

Mark Spencer: In September 2023, the consumer price index was at 12.2%, down from 14.8% in July. Industry analysis expects that food price inflation will continue to decrease over the remainder of 2023. The Government are providing an average of £3,300 per household to support them with the cost of living this year and next.

Hannah Bardell: The West Lothian food bank in my Livingston constituency does an incredible job, just like food banks across the UK, but the reality is that it should not even have to exist. Folk are struggling more than ever, which is why the SNP has called on the UK Government to control supermarket price gouging, amid record profiteering, by introducing a price cap on staples such as bread and milk. Will the Minister help all our constituents by getting on with doing that?

Mark Spencer: If the hon. Lady compares the price of a shopping basket around Europe with the price here in the UK, she will see that the free market is doing a lot of work to suppress food inflation. We have a cheaper food basket than they have in France and Germany. She is, in effect, advocating communism. She should look at how that works around the world. Controlling those markets does not work.

Lindsay Hoyle: I call the SNP spokesperson.

Steven Bonnar: Prior to the Westminster crisis that has been inflicted on us all by the Tory party, a loaf of wholemeal bread cost £1.01. Even after a slight drop in food prices, the price is now 20% higher. We know the farmers are not benefiting from these price increases. The price of milk in supermarkets today is almost twice what we pay the farmers for their product. Why will the Government and the Secretary of State not consider price caps to stop the supermarkets profiteering and to help ensure that basic essentials are not beyond the reach of many people?

Mark Spencer: We have done an enormous amount of work in this area to help to support primary producers and farmers. We will legislate in the dairy sector to help to make sure those contracts are fair, and to make sure  we have fairness across the supply chain. The hon. Gentleman is advocating the control of market prices, which would have exactly the opposite effect of what he wants to achieve. It would drive up prices across the country, and we would end up in a far worse place.

Topical Questions

Philip Hollobone: If she will make a statement on her departmental responsibilities.

Therese Coffey: The Met Office has issued various warnings. Indeed, as the Under-Secretary of State for Environment, Food and Rural Affairs, my hon. Friend the Member for Taunton Deane (Rebecca Pow), pointed out, we are preparing for potentially significant storms, which is why the Environment Agency has mobilised its emergency operations centre and why temporary defences are being lined up in different parts of the country. We continue to encourage households to register for flood alerts and warnings and to take action, where appropriate.

Philip Hollobone: Ball Corporation has invested £200 million to create Europe’s largest and most modern aluminium drinks can manufacturing plant in Burton Latimer. Will the Secretary of State be kind enough to meet the company to explore her plans to support drinks can producers against potentially unfair market distortions as a result of the decision to exclude glass from the deposit return scheme?

Therese Coffey: I decided not to proceed with glass in the DRS because of the complications that would bring to its introduction; I would have thought his local company would benefit from that. However, I know that the chief executive recently had a constructive and useful meeting with the recycling Minister, the Under-Secretary of State for Environment, Food and Rural Affairs, my hon. Friend the Member for Taunton Deane (Rebecca Pow), who will take away the comments from that for further consideration as we finalise our policy.

Olivia Blake: I have received a host of emails from constituents, many with respiratory problems, who are rightly complaining about poor air quality. The smoke in the air was caused by heather burning on the moors, which resulted in a spike in poor air quality to levels that were four times the legal limit. Will the Government finally do the right thing and bring in an outright ban on these practices, which are affecting not only my constituents’ health, but the natural environment and the climate?

Therese Coffey: The hon. Lady will be aware of the action that has been taken—that Ministers required Sheffield City Council to take—to accelerate measures to improve air quality. On the wider measures that she talks about, we are not seeking to ban important practices, but of course things continue to evolve. Air quality is improving and she should be grateful not only to her local councils but to the Government for making that happen in her constituency.

Andrew Selous: Dunstable downs rotary club is paying for 4,000 trees to be planted at Chute wood, on Dunstable downs. Will the Minister commend this action and commend other organisations to do likewise, given the crucial importance of tree planting in combating climate change?

Trudy Harrison: That was worth the wait! I will absolutely commend Dunstable downs rotary club, and the work that this Government are undertaking, because trees are essential. They are the larder and the shelter for our wildlife. They are vital for our ecosystem. They protect us from flooding, prevent us from overheating and are at the forefront of this Government’s plan for the environment. That is why we are rolling out local nature recovery strategies to support more good volunteering in our local authorities.

Dan Jarvis: Will the Minister give an update on work that is taking place to alleviate the impact of avian influenza?

Mark Spencer: Work is ongoing on avian influenza. The hon. Gentleman will be aware that we have suffered two years of catastrophic effects of that disease. Animal and Plant Health Agency vets are working round the clock with primary producers to protect their flocks. I do not want to jinx myself, but at the moment we are making good progress. We will continue to work hard with the sector to protect it and ourselves from that terrible disease.

Kit Malthouse: As the Secretary of State knows, my constituency is chalk stream central, with the headwaters of the celebrated River Test, the Bourne rivulet and the River Anton, which runs through Andover. What can the Government tell me to reassure my constituents that the unique ecology of chalk streams is uppermost in their mind as they work to enhance our rivers across the country?

Therese Coffey: As my right hon. Friend knows, I know that area well. I used to live in Whitchurch, which has the River Test flowing through it. We are making progress with our chalk stream action plan, but he will also be aware of the amendment that the Government agreed to work with Viscount Trenchard on and which is now part of the Levelling-up and Regeneration Bill, which I hope will become an Act very soon.

Jamie Stone: Some of the finest seed potatoes are grown in the north of Scotland. Right now, the seed potato farmers are worried sick, because a lot of their crop is below water. That also poses a question mark over the supply of seed for next year. I know that this matter is devolved, but as the Minister is a farmer will he put the maximum encouragement in the direction of the Scottish Government to please help the farmers?

Mark Spencer: The hon. Gentleman has done that with his question. I do not diminish the effect that the rain is having on the seed potato crop; once seed potato is under water for more than a week it will probably be destroyed. Scottish seed potatoes are some of the finest  seed produced anywhere in the world and I encourage him to seek contact with the Scottish Government to get them to help.

Mark Eastwood: Kirklees Council is looking to invest in its food waste recycling strategy, in line with the Environment Act 2021, but it is still waiting for full clarification and details that support that legislation. Will the Minister advise as to when that will be sent to councils?

Rebecca Pow: That clarification will be coming very soon and within it the new simpler recycling approach will include mandatory collection of food waste.

Dave Doogan: Publicly owned Scottish Water has invested £668 million since 2010 in improvements and committed another half a billion pounds between 2021 and 2027. That is why Scottish Water has had its product—the waters around Scotland—classified as being in “good ecological condition”. Why do English bill payers pay the most and get the mankiest water?

Therese Coffey: The hon. Gentleman is wrong about that. There is a lot of chatter about water; we should never undermine the cleanliness of the drinking water that people enjoy. The interministerial group is working on different ways of measuring ecological status across the United Kingdom and we are looking to see what we might do about that. We made the change in 2016, which other parts of the United Kingdom did not, and we continue to work together as responsible Governments. I remind the hon. Gentleman, only 4% of storm overflows in Scotland are monitored—they would be better off getting on with that.

Attorney General

The Attorney General was asked—

Kerry McCarthy: What recent assessment she has made of the adequacy of the Crown Prosecution Service’s written responses to complaints.

Michael Tomlinson: Although progress has been made, the CPS acknowledges that there is more to do to ensure that every complaint gets a high-quality response in a timely manner. I will be discussing this very issue with the Director of Public Prosecutions at our next meeting.

Kerry McCarthy: I am sure the Solicitor General will be aware that the CPS Inspectorate recently conducted an investigation into the response to complaints from victims of crime. It found that almost half were below standard and only a third were “adequate”. Do victims of crime not deserve better?

Michael Tomlinson: I am grateful to the hon. Lady for her serious and important question. It is of the utmost importance that victims are well supported by all parts of the justice system. Improvements need to be made. It might be worth pointing out that in the Inspectorate’s report, the complainants were looked at, from victims, defendants, witnesses, the police and others. There is clearly some way to go, but the CPS has accepted each and every one of the recommendations.

Russia: International Accountability

Michael Fabricant: What recent steps she has taken to establish international accountability for Russia’s actions against Ukraine; and if she will make a statement.

Tom Randall: What recent steps she has taken to establish international accountability for Russia’s actions against Ukraine.

Victoria Prentis: We are supporting my counterpart in Ukraine, Andriy Kostin, and Ukraine’s judiciary with an ongoing package of practical assistance. They have opened over 100,000 files into alleged Russian war crimes. There is a growing body of evidence that serious crimes have been committed. Together, we will ensure that allegations of war crimes are investigated robustly and independently.

Michael Fabricant: While the House is naturally focused on what has happened in the middle east and the Hamas attack against Israel, the war in Ukraine continues. What assessment has my right hon. Friend made of the abduction of young children from Ukraine to Russia?

Victoria Prentis: Forced deportation of children is particularly abhorrent. In July, the Foreign Secretary announced 40 new sanctions against Russian officials who have been involved in the forced deportation of Ukrainian children and the spreading of hate-filled propaganda. We continue to work closely with the Ukrainians. I am seeing Andriy Kostin in person again next week, and we remain involved at all levels, from the International Criminal Court to local prosecutions.

Tom Randall: In the context of Russia’s aggression against Ukraine, what steps is the Attorney General taking at international judicial level to ensure the rule of law is upheld?

Victoria Prentis: At the end of last month, I was honoured to appear personally before the International Court of Justice in The Hague. I made the UK’s submissions in the case against Russia concerning the genocide convention. It was an important moment for the international rule of law. I fear this will be a long process, but we will pay our full part.

Jim Shannon: I thank the Attorney General for her response and understanding of our requests. Unfortunately, one thing that is not mentioned much about Ukraine is that when east Donbas was invaded and Crimea was taken over, many Baptist pastors went missing. They were abducted, kidnapped and killed, and nobody has been held accountable. Will the Attorney General intervene in that situation and help to give accountability to those families who have lost loved ones?

Victoria Prentis: The hon. Gentleman always speaks so passionately, particularly on behalf of those involved in helping others with their religious beliefs, making sure that they are not persecuted around the world. I have heard what he has said.

Lindsay Hoyle: I call the SNP spokesperson.

Patricia Gibson: The Attorney General has rightly said that international accountability for Russia’s actions in Ukraine is very important. She will also be aware that some deep concerns have been expressed that Russia may be exploiting the very volatile and fragile situation in Israel and Palestine, with its reportedly close links with Hamas and accusations of facilitating international terrorism. Does she share those concerns, and what efforts does she think the international community can take to counter that?

Victoria Prentis: The UK has a strong track record of supporting international law, and we ask that our friends and partners do the same. It is clear to us that all parties should abide by international law. It was very much brought home to me in that room in The Hague that Russia and Ukraine have not been in many rooms together during the past 18 months, but a courtroom brought them to the same place, and that shows the power of international law.

Crown Prosecution Service: Access to Justice

Jeff Smith: What recent assessment she has made of the effectiveness of the Crown Prosecution Service in ensuring access to justice for victims of crime.

Tan Dhesi: What recent assessment she has made of the effectiveness of the Crown Prosecution Service in ensuring access to justice for victims of crime.

Victoria Prentis: The Government are committed to ensuring that victims are treated fairly and compassionately. We know that joined-up working across the criminal justice system works, and we know that supporting victims makes a real difference. That is why we are spending four times as much on victim support as was the case in 2010.

Jeff Smith: There are victims of crime in our country who have had to wait years for their cases to come to court, who have bravely given testimony to ensure that the criminals who robbed or attacked them are convicted, and who, this week, will have to watch those criminals be bailed rather than jailed, because the prisons are too full to pass sentence against them. What message would the Attorney General like to send to those victims?

Victoria Prentis: The message that I want to send to victims today is that they are very important to this Government. We want them to come forward and we want to investigate and prosecute the crimes of which they are the victims as well and as expeditiously as we can. I listened to what the Lord Chancellor had to say on Monday and I was impressed that he is putting those prison places in the right part of the system, focusing on those serving time for longer, more violent and more worrying offences, with those at the other end of the prison system—those on that revolving wheel of going in and out of prison—being treated in a different way. We want and he wants—it was clear to me that he feels this very strongly—to reduce crime, and he is making sure that the whole of the criminal justice system and the prison system works to achieve that aim.

Tan Dhesi: Shockingly, according to the latest figures, more than 6,400 Crown court cases have been waiting more than two years to be heard. That is up more than two thirds on last year alone. What does the Attorney General have to say to the victims, who, to their despair, have found that their lives have been put on hold while they are waiting for justice? And what does she say to those who can no longer cope with any more delay even if that means having to let their case collapse?

Victoria Prentis: I am happy to say that the hon. Gentleman and I share a local Crown prosecution area in Thames and Chiltern where the local victim attrition rate is well below the national average. It is running at about 13%. Any attrition is too high, and we want to make sure that we support victims to enable them to continue to bring their cases. That is why we have put in place about 800 independent sexual violence advisers to help those victims feel supported and able to go to trial.

Andrew Selous: A couple of weeks ago, we had a series of very distressing break-ins to small owner-manager businesses in Leighton Buzzard High Street. I know that the owners and Bedfordshire police were disappointed in the response of the CPS. Would it be possible to get the CPS together with those business owners to try to improve things in the future?

Victoria Prentis: I am sorry to hear about those distressing cases. Of course, either the Solicitor General or I would be delighted to meet our hon. Friend to discuss this further.

Lindsay Hoyle: I call the shadow Attorney General.

Emily Thornberry: Last month, I had the pleasure of hosting the brilliant Women’s Budget Group in Parliament for the launch of its report on gender gaps in access to civil justice. Across the board, from employment and benefits to domestic violence and housing, the report found too many women reaching crisis point before they got the help that they needed, as well as increasing numbers getting no help at all and having to represent themselves in court. Will the Attorney General raise those findings with the Justice Secretary and look at how the Government can address the disproportionate impact on women of our country’s legal aid deserts?

Victoria Prentis: The right hon. Lady makes an important point. I read with interest some of the work that she had been doing with others for whom I have enormous respect in this important area. I know that she is very capable of raising those matters herself with the Justice Secretary, but I reassure her that the access of everybody to justice is very much at the top of my agenda and his.

Violence against Women and Girls: Prosecution Rates

Alex Cunningham: What steps she is taking to increase prosecution rates for cases relating to violence against women and girls.

Ruth Jones: What steps she is taking to increase prosecution rates for cases relating to violence against women and girls.

Victoria Prentis: We are committed to tackling violence against women and girls, and have introduced new specific offences to target those crimes. We are steadily increasing the number of rape prosecutions. We are working on new ways to recognise the relationship between rape, domestic abuse and stalking. Close working across the system is the key to effective prosecution.

Alex Cunningham: At Labour’s recent conference in Liverpool, my right hon. Friend the shadow Attorney General highlighted the shocking statistic that it is 200 times more likely for a woman to be a victim of stalking in this country than it is for her stalker to go to jail. Does the Attorney General agree that it is time that we started treating stalking with the seriousness that it deserves, including giving victims of online stalking a right to know the identity of their stalker?

Victoria Prentis: I thank the hon. Gentleman for raising that important issue, and I reassure him that the Government are absolutely committed to helping stalking victims to bring their cases to prosecution. The Lord Chancellor has made that something of a mission during his time in the House; I remember my many years with him on the Justice Committee when he talked of little else. We are working in the CPS on new ways of ensuring that the complicated relationship between rape, domestic abuse and stalking is properly considered across the system.

Ruth Jones: Prosecution rates for violence against women and girls remain low, and that simply is not good enough. Next month, we will mark White Ribbon Day, when men show their commitment to ending violence against women and girls. What discussions has the Attorney General had with colleagues across Government about White Ribbon Day, and what more can be done to increase prosecution rates and eradicate violence against women and girls once and for all?

Victoria Prentis: A great deal of work is going on across Government to tackle violence against women and girls, and I am pleased to tell the hon. Lady that a great deal of really good work is happening in her area in Wales. When I visited the Cardiff office earlier this summer we had some very productive discussions about the implementation of the new CPS charging model. I encourage her to meet Jenny Hopkins, who is the chief Crown prosecutor for her specific area, to hear more about how that hard work has brought some really positive results.

Lindsay Hoyle: I call the Chair of the Justice Committee.

Bob Neill: Just before the recess, the then Director of Public Prosecutions gave evidence to the Justice Committee and highlighted the specific areas of work being done to improve the victim experience in relation to rape and serious sexual offences. While there is more to do, would the Attorney General accept that there has been real progress from the position even, say, 10 years ago? What is the latest position in relation to the key targets that were set from the end-to-end rape review?

Victoria Prentis: I thank my hon. Friend for his question, and for reminding me that I should pay tribute to the outgoing DPP, Max Hill, for his five years of excellent work on our behalf prosecuting crime. I am sure that all of us across the House would like to wish him well in the next stage of his career.
On my hon. Friend’s specific question, the rape review set challenging targets. We have worked very hard across Government—the Home Office, AGs and the Ministry of Justice—on three of those targets in particular, and we are exceeding them considerably. We are in a much better place. Many more cases of rape are being prosecuted and rapists are being convicted. We need to continue to build on that progress—we will not rest on our laurels—but there has been real improvement. If anybody is a victim of rape, I encourage them to come forward. We will support them, and we will prosecute.

Solicitors: Civil Society

Chris Stephens: What recent discussions she has had with the Secretary of State for Justice on the contribution of solicitors to civil society.

Michael Tomlinson: As my right hon. Friend the Lord Chancellor agrees, solicitors and, indeed, all legal professionals play a vital role in upholding the rule of law. As Solicitor General, I take this opportunity to thank Government Legal Service lawyers for their exceptional work every day, often under pressure, on some of the most high-profile cases in the country.

Chris Stephens: That is all very well, but the Justice Minister denounces lawyers for parading their politics, while the Home Secretary believes that there is a racket of “lefty lawyers” undermining the law. Does the Attorney General not agree that, instead of deflecting blame from the serial ineptitude of a broken Home Office decimated by her colleagues, she should stand up for the profession as impartial arbiters of the rule of law?

Michael Tomlinson: The Attorney General and I often meet legal leaders across the profession both to celebrate their achievements and to hear their concerns. It is right to say that lawyers acting in the best interests of their clients should never be criticised for so doing. But it is also right to say, as the Lord Chancellor has also said, that it is the strong tradition of lawyers in this country that they simply act for their client without fear or favour and do not necessarily associate themselves with the cause. I agree 100% with the Lord Chancellor.

Sally-Ann Hart: What assessment has the Solicitor General made of the strength of the legal profession in rural areas?

Michael Tomlinson: Mr Speaker, you have heard about the “law tour” that the Attorney General and I recently entered into. We met some lawyers in Welshpool and heard from high street solicitors about the importance of their practice, not only in Wales but on the Welsh borders. My hon. Friend should look out for more details about the law tour.

Serious Fraud Office Director

Andrew Jones: What assessment she has made of the implications for her policies of the appointment of the new director of the Serious Fraud Office.

Michael Tomlinson: The Attorney General and I met the new director, Nick Ephgrave, yesterday and discussed the SFO’s priorities, including continuing to deliver its day-to-day mission and driving forward lasting improvements to its operations.

Andrew Jones: I have been contacted by constituents who have been victims of financial scams carried out by large organised criminal gangs, which often target the more vulnerable in our communities. What steps is the Solicitor General taking to end the scourge of these frauds and scams, and will it be a priority for the new director of the SFO?

Michael Tomlinson: I can tell my hon. Friend that the SFO announced a criminal investigation just last week into a suspected fraud at Safe Hands Plans, a funeral plan provider with 46,000 plan holders before its collapse last year. My hon. Friend has raised this very point during an earlier debate, and I am grateful to him for that. I am sure that he will agree that the announcement of the SFO’s investigation is a significant and welcome step.

Barry Sheerman: Will the new head of the SFO take the job very seriously and look again at some of the big fraudsters and at the penalties? Will the Solicitor General ask the new director why Bernie Ecclestone did not go to prison for massive fraud against the tax system?

Michael Tomlinson: The hon. Gentleman gives me the opportunity to pay tribute to the new director. He is the right candidate for the job. He brings a wealth of experience. He will listen to what the hon. Gentleman says and to what we all say in this Chamber. He has   expertise in leading large, complex and multidisciplinary law enforcement organisations, and we look forward to supporting him in his work.
His Majesty’s Crown Prosecution Service inspectorate inspects not only the CPS, but the SFO, so it was remiss of me earlier not to pay tribute to the inspectorate and to the chief inspector for his work.

Lindsay Hoyle: I call the shadow Minister.

Andrew Slaughter: I join the Solicitor General in welcoming Nick Ephgrave as he takes on one of the most difficult jobs in law enforcement. His arrival in post was announced by the SFO abandoning the three long-running and expensive prosecutions of Rio Tinto, Eurasian Natural Resources, and the Alpha and Green Park group. That follows a chain of failed cases, from G4S and Serco to Unaoil. With permanent staff vacancies of around 25%, and a case load that has fallen by half in recent years, why should the new director think that this lame duck Government will make the SFO a hawk in the world of financial crime?

Michael Tomlinson: I will ignore the snide comment at the end but I will address the substance of the hon. Gentleman’s question, which he is right to ask. It is also right to say that it is always disappointing when cases are closed, but criminal investigations that no longer meet the public interest test, as he well knows, simply cannot continue. That is the code that Crown prosecutors take, and he will understand why that is the case. It is right to trumpet the SFO’s achievements; it is also right to challenge it. I know that staff recruitment and retention will be one of the priorities for the new director.

Barry Sheerman: On a point of order, Mr Speaker. During Question Time, the Secretary of State for Environment, Food and Rural Affairs said that air quality in our country was improving. There is no evidence for that statement and, although I do not believe that she meant to, she misled the House.

Lindsay Hoyle: If there is no evidence, we will never know whether she did or did not.

Business of the House

Lucy Powell: Will the Leader of the House give us the business for next week?

Penny Mordaunt: The business for the week commencing 23 October is as follows:
Monday 23 October—Second Reading of the Renters (Reform) Bill.
Tuesday 24 October—Motion to approve the draft Criminal Justice Act 2003 (Removal of Prisoners for Deportation) Order 2023, followed by consideration of a Lords message to the Levelling-up and Regeneration Bill, followed by a debate on the fourth report of the Procedure Committee, on correcting the record.
Wednesday 25 October—Consideration of a Lords message to the Economic Crime and Corporate Transparency Bill, followed by consideration of Lords amendments to the Non-Domestic Rating Bill, followed by, if necessary, consideration of a Lords message to the Procurement Bill [Lords], followed by, if necessary, consideration of a Lords message to the Energy Bill [Lords], followed by Report stage of the Economic Activity of Public Bodies (Overseas Matters) Bill, followed by, if necessary, consideration of any further Lords messages.
Thursday 26 October—If necessary, consideration of Lords messages, followed by a general debate on menopause. The subject for this debate has been determined by the Backbench Business Committee, followed by, if necessary, consideration of Lords messages.
Friday 27 October—The House will not be sitting.
The House will be prorogued when Royal Assent to all Acts has been signified.

Lucy Powell: May I first take a moment to remember our former colleague Sir David Amess, who was brutally murdered two years ago while carrying out his duties? His memory and legacy still shine brightly.
As we continue to witness the horror of the events unfolding in Israel and Gaza, and the emotions that they raise here at home, Hate Crime Awareness Week is a timely reminder that we stand united against hate. The whole House speaks with one voice against antisemitism and Islamophobia. As Members, we know that events in the middle east are directly and indirectly impacting on our constituents. We stand in solidarity.
We condemn unequivocally the heartless terrorist actions of Hamas. Israel has the right to defend itself, rescue hostages and protect its borders. International law must be upheld at all times. The lives of innocent civilians must be safeguarded, and every possible assistance must be made available to those who need help. There must be immediate humanitarian access to Gaza for aid, food, water, medicines, fuel and electricity. We welcome developments today, but it is urgent and it needs to be sustained. Hamas are not the Palestinian people, and the Palestinian people are not Hamas. We will continue to be strong advocates for justice, human rights and international law, and to keep alive the  prospect of peace based on a two-state solution. Will the Prime Minister update the House following his visit this week?
I am afraid that I return again to a running theme: the disrespect and disregard that the Government have for Parliament. Mr Speaker, I know that we were both appalled that the Prime Minister chose the very first day of recess to announce a major shift in Government net zero policy from Downing Street, while the Leader of the House sat in the front row and cheered. It is no wonder he was ducking parliamentary scrutiny, with his fiction of seven bins and meat taxes, and his substance was met with alarm by industry and investors.
It is not a one-off but a pattern, no matter how many times you pull them up on it, Mr Speaker. Again this week the Justice Secretary announced first to the press that he is abolishing short prison sentences—something the ministerial code forbids. And of course, we have had the great northern train robbery, denied for weeks and finally announced at Conservative party conference. Despite MPs having spent 1,300 hours of legislative time on High Speed 2 Bills, we have had no say on it. Only this Prime Minister could cancel major rail infrastructure to Manchester while in Manchester.
This shoddy back-of-the-fag-packet new transport plan, affecting many constituencies, has not withstood exposure to reality. Most of the “new” schemes were already announced, previously cancelled or completed years ago. Others are simply illustrative. Euston station remains a pipe dream, and Network North now reaches Cornwall. It turns out that spreadsheet guy cannot even read a spreadsheet. It is not so much a relaunch as a crash landing—in a private jet, of course.
The contempt that this Government have for Parliament is a disgrace, and we have a Leader of the House who claps along. Parliament needs answers. What will now happen to the HS2 hybrid Bill, which is necessary to deliver the central section of Northern Powerhouse Rail and safeguard the land for it? When and how was the decision to scrap it made? The Secretary of State for Transport is under the illusion that he made it the day before—pull the other one!—yet the video shared from their party conference was clearly made days earlier in Downing Street. When was this taken, and should a party conference video be made in Downing Street at all?
There is another pattern here. Conservative HQ has released videos of Conservative Members and a Cabinet Minister announcing Government projects. Can the Leader of the House assure us that Conservative Members are not being given advance notice of Government announcements, and if they are, will she confirm that this breaches the ministerial code?
Finally, I want to congratulate the Leader of the House on achieving meme status for her conference speech. It was—how can I put this?—a call to arms to stand up and fight. Well, it certainly involved lots of arms, anyway. So why does she not stand up and fight for Parliament; stand up and fight for Members to hear Government policies first, or for colleagues not to be hoodwinked when big decisions are taken? Why does she not stand up and fight for trust to be restored in politics? The truth is that she is more interested in standing up and fighting for her own leadership ambitions. As a fan of boats, she should know that a new captain is not saving this sinking ship. It is time for them all to get off.

Penny Mordaunt: First, I thank the hon. Lady and join her in remembering our late colleague, Sir David Amess. His legacy lives on, not just in city status for Southend; the many charities and projects that he fostered are going from strength to strength, and they are a daily reminder of the work he did and the effect and impact he had.
I add my voice to those of many in this Chamber who have expressed their horror, sadness and sympathy with all those caught up in the situation in Israel and Gaza. My thoughts are particularly with those who have lost loved ones in the most barbaric terrorist attack, and with those taken hostage and their families who await news of them. At times like these, we in this place may feel that we cannot directly help, but we all can. We can all make judgments based on facts, promote those facts and debunk deliberate disinformation campaigns, keep informed and wide-eyed about the realities of the situation, and reassure communities here in the UK.
On behalf of all colleagues, I thank the armed forces, the Royal Fleet Auxiliary, our diplomats and humanitarian experts, and the police for all that they are doing to protect and secure people’s safety in the middle east and at home. I join the hon. Lady in saying that all of us in this place are united against hate. She will know that the Prime Minister and Foreign Secretary are currently in the region, and I am sure that they will want to update the House. I am sure that many colleagues will want up-to-date information, particularly about some of the situations that have happened in Gaza and the facts behind those situations. As such, I can also tell the hon. Lady that my office has been in touch with the House of Commons Library to ensure that what information is available is given in a timely way to Members of the House.
The hon. Lady criticises me very robustly about my role as this House’s representative in Government. I hope to be able to reassure the House of my record on that front. First, I hope that Mr Speaker would support me in saying that I have always followed up any criticism that this House has made of any Government Department —more, I think, than anyone else who has held the role. My noble friend Lord True and I have also introduced training programmes for Government Departments to ensure that they know what their obligations to this House are. Her complaint against me might have had more effect had the letter she wrote to me complaining about this issue not been received by myself only after it had been briefed to the Daily Mirror, which is where I found out about it.
I did cheer our announcement on net zero, unlike the Labour party, whose path to net zero would include immense burdens on working people. We have chosen a different path to alleviate that burden. The hon. Lady invites me to contrast our parties’ records on infrastructure, and particularly rail. I remind her that in the 13 years we have been in power, we have electrified 1,220 miles of track. In the same time period, Labour managed just 70 miles. I am not going to apologise for standing up and fighting for this country; even prior to taking this role, I think my record has been one of standing up and fighting for this House. Hon. Members will know that, in the first year of the pandemic, I spent every single day on the phone, to all Members of this House, in my role as Paymaster General, updating them on what was happening. I take my responsibilities to this House very seriously indeed.
I will always stand up and fight for this House and for my country. I will not be lying down with Just Stop Oil and damaging our energy security. I will not be potentially lying down with the Liberal Democrats—I note the hon. Lady’s encouraging words about proportional representation. I will not be lying down with the SNP, which the hon. Member for Edinburgh North and Leith (Deidre Brock) will be pleased to hear, and contemplating assisting that party on a second referendum. Those are the facts, and I can understand why Labour does not like them. That is perhaps why it has chosen to ban some news programming available on Freeview to anyone operating in the Senedd.
Further business may be announced in the usual way, or by His Majesty the King on 7 November.

Conor Burns: I associate myself with the words about our late colleague Sir David Amess. I was privileged to serve with him on the all-party parliamentary group on the Holy See, of which he was a dedicated chairman.
In considering future business, may I draw the Leader of the House’s attention to the collapse of a company in my constituency, Initiative Property Management, which manages a large number of residential blocks in my constituency and more widely? Since the collapse, many residents have seen building works on their blocks cease, and have been unable to access tens of thousands of pounds of their own money in management fees. While the matter is now being investigated by Dorset police—and I do not invite my right hon. Friend to comment on that—may I suggest that there may be a regulatory gap here? It appears that management companies of this style do not fall under the regulatory framework of the Financial Conduct Authority. I invite the Leader of the House to make Government colleagues aware of the fact, and perhaps ask them to take a look at it.

Penny Mordaunt: First, I thank my right hon. Friend for all the work he is doing at what must be a very worrying time for his constituents who are affected. He will know that the Government are currently considering the recommendations in the final report from my noble Friend Lord Best’s working group on the regulation of property agents. Of course, the Financial Conduct Authority currently has a limited role, and although we are not seeking to expand its role, we want to ensure that it can be a more innovative, assertive and adaptive regulator.

Lindsay Hoyle: I call the SNP spokesperson.

Deidre Brock: I associate myself with all the remarks about Sir David.
The Leader of the House has previously commented on how much she enjoys our exchanges at business questions, as do I. It is the weekly forum where I challenge her on our deep and profound differences in policies and priorities, and there will be plenty of opportunities in the next few weeks and months to tackle her on her Government’s shortcomings. However, today, like so many people, my thoughts are with the civilian populations in Gaza and Israel. People across all nations of the UK share this House’s revulsion and fear of what we see unfolding—revulsion at the barbarism of Hamas and fear of what the future holds for innocent children, women and men in both Gaza and Israel. A huge  number of MPs have constituents who are worried sick about friends or relatives who are caught up in these events, and of course communities across the UK will be anxious about what we are witnessing and its potential impact. As the House will know, Scotland’s First Minister, Humza Yousaf, and his wife and family are directly affected in the most terrible way, and my thoughts are also with them today.
The UK Government have several roles to fulfil in this crisis, and there is an urgent need for action, as we all know. In the first instance, they must direct their efforts to the enormous humanitarian aid needs in southern Gaza—medical supplies, water, food, basic power. Twenty trucks is a start, but there are apparently 100 standing by and they must get through. However, they need to travel safely through, so calling for an immediate ceasefire to facilitate the provision of aid in Gaza and to give evacuees a safe passage out is vital, as is the release of all the hostages—one’s heart breaks to think of them—and the use of every possible diplomatic effort to stop an escalation into a wider regional conflict. The Government should join First Minister Humza Yousaf in calling for a worldwide refugee scheme similar to that established for Syrian, Afghan and Ukrainian refugees. In the longer term, they should use all their powers to keep the two-state solution alive and keep a dialogue for peace open. They must rise to many challenges, and we wish the Prime Minister well in his endeavours today. Will the Leader of the House confirm that he will deliver a statement about the outcome on his return?
Of course, we will return to the business of scrutinising the Government’s actions in the usual way when politics returns to some sort of normality, hopefully very soon.

Penny Mordaunt: I thank the hon. Lady for dwelling on that particular matter, because I think that is the prime concern for all Members of the House this weekend. I join her, as I am sure all colleagues will want to, in her sentiments about the plight of the First Minister’s family and in wishing that that has a good outcome.
The hon. Lady will know that additional humanitarian support is being provided by the Government to the region, which is built on many years of providing support. We are one of the major contributors to the United Nations Relief and Works Agency, and we have done a huge amount of work in Lebanon to support the refugee programmes there. So we bring not just the financial offer, but decades of expertise in working in the region and with our networks. Of course we want hostilities to end, but I would just say to the hon. Lady that we are dealing with a terrorist organisation, and negotiating ceasefires with terrorist organisations is a very difficult thing to do.
The hon. Lady is right to highlight the plight of hostages, and one way we can all help is by keeping a focus on those individuals and their families in the coming days—I hope not weeks—and on their return. This is another area where the UK has a lot of expertise to offer. Israel will not have had a lot of expertise in hostage negotiation. Not just the Government but our non-governmental organisations have huge experience of working with organisations such as the International Committee of the Red Cross and interlocutors in trying to get hostages extracted. I know that all we can do to help will be on offer. She is also right to point to the fact that the barbaric terrorist attack that kicked off this  chain of events is in part designed to wreck any chance of peace, in particular the progress that was being made between Israel, Saudi Arabia and others in normalising relations. I thank her for the opportunity to send a message from all of us in this House that this is our focus and concern.

Siobhan Baillie: An incredibly impressive Stroud constituent called Sally-Anne came to see me last week about the contaminated blood scandal. Her father is a haemophiliac and is sadly affected by what we now know is a national and international scandal; families have spent decades seeking answers and compensation. Sally-Anne has turned her pain and her worry for her father into action, and she is doing a PhD to look at the wider impact on families, and at the McFarlane Trust work. I know that the Leader of the House is incredibly respected on this issue, and she has fought for victims of the infected blood scandal for many years. Will she clarify how I can best use time in this House to push those issues for the wider families affected, and say whether a debate or other actions will assist?

Penny Mordaunt: I thank my hon. Friend for all the work she is doing to support her constituent, and to ensure that those affected and infected by that appalling scandal get justice swiftly. If she secured a debate on this issue, it would be most welcome and well attended by many across the House. I have said this before, but we should recognise that even though we are talking about a small number of individuals as a percentage of the population, this issue is relevant to everyone in this country. What happened to those individuals could have happened to anyone in this country, and how we respond to that is important. That is why I am pleased that this Government have set up the inquiry, why I set up a compensation study to run concurrently with the inquiry, and why we must ensure that we press forward with getting those people some recompense for all they have suffered.

Lindsay Hoyle: I call the Chair of the Backbench Business Committee.

Ian Mearns: I am grateful, Mr Speaker. May I ask you and the Leader of the House to help us by helping to facilitate the re-establishment of the Backbench Business Committee as soon as possible after the King’s Speech in the new parliamentary Session? I will be writing to the Leader of the House with a list of as yet unaired debates from this Session which might be held prior to the re-establishment of the Committee in the new Session. We have applications for debates in this Chamber and in Westminster Hall on subjects such as protection for children with allergies, heritage pubs, floating offshore wind generation, knife crime, and several others.
I declare an interest as chair of the all-party parliamentary group on rail in the north. Yesterday I had a meeting with the Rail Industry Association’s northern section, and we were reflecting on what the chair of the National Infrastructure Commission said yesterday in urging the Government not to sell off too quickly land acquisitions for High-Speed 2 on cancelled northern routes. Those land acquisitions may well facilitate other schemes in the northern regions, and we hope that the Government would not sell those assets off too quickly.
Finally, as part of the crisis in Israel, Palestine and Gaza, a number of families in my constituency have been affected. Prior to the horrific Hamas attacks was the Jewish festival of Sukkot. A number of families from my Orthodox Haredi Jewish community were in Israel celebrating Sukkot and then became stranded and could not get home. Some have had to pay eye-watering sums to travel home by alternative means, because lots of flights were cancelled. Will the Leader of the House help me and those who have had to pay out sometimes whole-life savings to get their families of six or seven back home from Israel?

Penny Mordaunt: I thank the hon. Gentleman for a helpful advert for future potential business for his Committee. We have had conversations about this matter before, and I am keen to ensure that the Committee is re-established quickly so that it can get on with its important work. He raises an important point, with which I agree, that it is important that things have a proper masterplan, so I will write to make sure that the Secretaries of State for Transport and for Levelling Up, Housing and Communities have heard what he has said today. The hon. Gentleman will know that in cases where people are unable to return because they cannot afford to get out of a situation, there are schemes in place, run by the Foreign Office, under which people may be loaned finance. Many insurance products will not cover terrorist events, so I will make sure that the relevant Department has heard his concerns on that front.

Katherine Fletcher: My right hon. Friend the Leader of the House will be aware that in Lancashire we have secured £2 billion at least for a brand-new hospital to replace the much-loved but ageing Royal Preston, which has cold, dark corridors and a flat roof that can occasionally leak. With a number of sites in South Ribble under consideration, it is down to the wonderful Lancashire Teaching Hospitals NHS Foundation Trust, Lancashire County Council and local borough authorities to get on with that site selection. I hope, like me, that she would love to see them get on with that. With Chorley hospital’s future secured as one of only eight elective surgical hubs in the country, does my right hon. Friend agree that this Government are committed to delivering a once-in-a-generation investment in healthcare in South Ribble? Can we have a debate in Government time about the importance of these investments for local communities?

Penny Mordaunt: First, I congratulate my hon. Friend and thank her for all the work she has done to secure the £2 billion-worth of funding for her hospital, and also for managing to secure one of those critical elective hubs. That is an achievement of which she should be proud. She is right that we are committed to the biggest programme in a generation of hospital building. We are also prioritising the delivery of 160 community diagnostic centres, which are so important to ensuring that people are getting healthcare in a timely way. I am sure if she wanted to apply for a debate on those topics, it would be well attended.

Andrew Western: The Warburton toll bridge is a vital route, linking Greater Manchester and Cheshire across the Manchester ship  canal. A recent consultation of local communities on a proposed eightfold increase to the toll charge was met with unanimous opposition, including from Partington and Carrington in my constituency. Despite that, the Secretary of State for Transport has approved the associated transport and works order. Can we have a debate in Government time on the steps that should be available to Members to challenge such decisions and, importantly, how we can strengthen the voice of local communities, such as Partington and Carrington, to ensure they are heard fully in decisions of this nature in the future?

Penny Mordaunt: I thank the hon. Gentleman for raising this important matter. He will know that I will not be able to comment on particular schemes, but I will make sure that the Secretary of State for Transport has heard about that scheme. It is important that local voices are listened to when such matters are put in place. I question the relationship between the works order that the Secretary of State has signed and the fee, but I will certainly look into this matter for the hon. Gentleman. If he would like to give me some further information, I will be happy to write on his behalf.

Ian Liddell-Grainger: I wonder whether we could have a debate in Government time about Liberal Democrat councils—something we could spend hours on. The Government have very kindly given Mid Devon £660,000 for new housing, and I am grateful to Ministers for that, but the problem is that it has been given to a council that is inept. It has a development that is going wrong now. The leader of the council, who doubles up as a perfume-packing guy called Eau de Toilette and is the member who deals with scrutiny, is appalling. Can we please have time to discuss giving money to councils that are not able to spend it properly? We need Government control to ensure the money is spent wisely.

Penny Mordaunt: I am sorry to hear of another ongoing concern for my hon. Friend’s constituents. It is important that, when money is distributed, it is given to bodies that will get on and do what is needed. Sometimes, local authorities are not the best bodies to do that, which is why, when I was looking after the coastal communities fund, I always kept open the option for local community groups, charities and organisations that would qualify to be monitoring officers for such funds to administer them. I shall ensure that the Secretary of State for Levelling Up, Housing and Communities has heard his concerns.

Barry Sheerman: Will the Leader of the House consider arranging for a statement or an early debate on the dangers of gambling and the gambling industry’s impact on children and young people? There is increasing evidence that these big gambling concerns are using social media to get children engaged in gambling at an early age, as well as many vulnerable people. May we have a debate on the power and influence of this massive, wealthy industry?

Penny Mordaunt: The hon. Gentleman raises an important point. He will know that there has been a focus on all aspects of gambling, including online and offline gambling and the level of stakes spent by individuals. If he were to apply for a debate, there would be much to  discuss and it would be well attended. I will ensure that the Secretary of State for Culture, Media and Sport has heard what he said.

Theresa Villiers: Could we have a debate on media reporting of the conflict between Israel and Hamas so that we can hold to account those media outlets that chose to rush to blame Israel for the hospital tragedy without a sound evidential basis? Accurate reporting is crucial. Failing to deliver that makes the situation worse, could cost lives and could fuel hatred and antisemitism here in the UK.

Penny Mordaunt: I thank my right hon. Friend for raising that important point. There are two issues. One is the Ofcom code and certain broadcasters’ adherence to it. The guidance for that code says:
“Broadcasters should have regard to the list of proscribed terror groups or organisations in the UK”,
which is incredibly important. It is also critical that reporters, sometimes stationed in very stressful environments, report facts as facts and that those things that are not facts—things that have not been verified or are lines to take from terrorist organisations—should not be treated as facts. The BBC does focus on these things to a very large degree, but we know that sometimes it does not get things right, as we saw recently with its code of conduct surrounding the Gary Lineker situation. I am sure that it will want to kick the tyres on this and ensure that anyone listening to a BBC outlet is being given the best possible information.

Wera Hobhouse: On behalf of the Liberal Democrats, I echo what has been said this morning about the terrible conflict in Israel and Palestine and repeat what my hon. Friend the Member for Oxford West and Abingdon (Layla Moran) said: peace is now more difficult than war, so the global community has to come together and press for peace.
Many of my constituents have written to me in dismay about seasonal variations in train fares. For example, during recess, Great Western was charging £46 for a peak return from Bath to London on 17 November. For the same journey on 30 November, the cost has shot up to £94—more than double. May we have a statement from the rail Minister on why such large variations in prices are allowed and what the Government can do to make train prices more transparent?

Penny Mordaunt: The hon. Lady raises a concerning matter that will make life difficult for her constituents, who are trying to budget and anticipate their outgoings. I will certainly ensure that the Transport Secretary has heard her concerns, and I will ask that his Department advise her on what action she can take.

Martin Vickers: The Grimsby Telegraph is carrying a report of a local man who, for the last 25 years, has been collecting fly-tipped rubbish from various sites around the town. After 25 years, he has now been told that he needs a licence to take the rubbish to the tip. That is just one example of so many petty regulations that discourage community-minded people from assisting in the local area. Could we have a debate so that Members from across the House can identify those petty regulations and sweep them away?

Penny Mordaunt: I thank my hon. Friend for raising that point and for affording us the opportunity to thank his constituent, who appears to be providing a much-needed community service that his local authority is not. We want people who want to step up, take responsibility and help their communities to be able to do so. He is right to call out ridiculous behaviour that prevents that from happening. I am sure there are other examples and, if he were to have a debate, we could expose some of them.

Diana R. Johnson: Could we please have a statement from the Paymaster General in the light of Sir Brian Langstaff moving his final report on the infected blood inquiry to next March, due to the number of individuals and organisations that will be criticised in it, and in the light of the fact that the Government have rightly given £600,000 in compensation to the victims of the Horizon scandal without waiting for the final report? It would be very timely to have a report because we know that the Government were working to the November deadline. We keep being told that work is “at pace”, so it should be ready for next month in any event.

Penny Mordaunt: I thank the right hon. Lady for raising this matter and for all her work through the all-party parliamentary group on haemophilia and contaminated blood, which she has chaired for many years. It is not lost on anyone that those individuals have waited far too long for redress in this appalling situation. I know that the Paymaster General feels that way, too, and I will ensure that he has heard her request for him to update the House.

Douglas Ross: At its conference this weekend, an SNP MP said he was “sick and tired” of Scottish Conservatives speaking in Parliament about the A9. The Leader of the House will know that that is a crucial road between Perth and Inverness and up to Wick which the SNP promised would be fully dualled. That is not happening. Can we have a debate in this House to discuss that crucial infrastructure project? Perhaps the hon. Member for Perth and North Perthshire (Pete Wishart) will attend and stand up for his constituents, rather than sit down and support the SNP Government’s failure to dual that road and the A96 through my constituency.

Penny Mordaunt: I thank my hon. Friend for raising that important point. I happened to see what I would describe as a spittle-flecked monologue, criticising members of the general public in Scotland for daring to voice their disappointment at the quality of the A9 and other road infrastructure. My advice to the hon. Member for Perth and North Perthshire (Pete Wishart) is that if he does not want the public to continually complain about things, he might dual those roads, as that project has been long overdue. The public should have decent roads for the taxes they pay.

Rosie Winterton: Order. I presume that the hon. Gentleman informed the hon. Member for Perth and North Perthshire (Pete Wishart) of his question?

Douglas Ross: Yes I did, Madam Deputy Speaker, and he responded to thank me.

Rosie Winterton: It is useful for me to know that you have done that.

Andrew Bridgen: When a Government announce that they have identified a problem facing the public and simultaneously announce that they have identified the only possible solution, I am always a little sceptical. Twenty years ago, the Labour Government announced that diesel vehicles were best for the environment; today, as we know, they are vilified and effectively being taxed off the road. We are now told that electric vehicles are our only salvation, despite growing concerns about their safety and real questions about the true environmental cost of manufacturing and disposing of their lithium batteries. May we have a debate on the costs and benefits of electric vehicles?

Penny Mordaunt: The hon. Gentleman will know how to apply for a debate in the usual way. He has recently applied for debates and I think he has a debate on another topic later this week. The House is always happy to facilitate that. He is absolutely right: we want to ensure that information is taken from a wide range of sources. Historically, there have been scandals; we had the EU emissions scandal related to diesel vehicles. It is very important that information is out there and people can scrutinise it. I encourage all Members to make use of the House of Commons Library, which is a tremendous repository of information, but also to take their information from a wide variety of sources.

Bob Blackman: It is understandable that, after suffering the worst terrorist atrocity in its history and the largest loss of Jewish life since the holocaust, the state of Israel will now seek to eliminate the threat of Hamas and all the other terrorist organisations. Mr Speaker enabled a statement on Monday and then an urgent question. Rather than a statement, would it not be better for the House to have a debate, in Government time and on a Government motion, so that it can express its support for the state of Israel and we can come to a ready conclusion to send a strong signal? Does the Leader of the House agree that there can be no equivalence between the Hamas terrorists, who kill, maim and torture civilians and try to eliminate as many Jews as they possibly can, and the Israel Defence Forces, which seeks to target terrorists and minimise civilian casualties?

Penny Mordaunt: I think that many Members of this House would want further opportunities to discuss this very important matter, so I suggest to my hon. Friend that he pursues the idea of a debate.
There has been discussion over the last week of proportionality, and the term “collective punishment” has been used on the Floor of the House. It is incredibly important that we recognise that the International Committee of the Red Cross principle of proportionality does not mean an eye for an eye, as some have suggested. That would be perverse. We do not suggest via that very important principle that, if the Israel Defence Forces raided Gaza and beheaded a precise number of infants or burned a precise number of families or raped a precise number of women and girls, that would be okay—of course not. That is not what proportionality means. The principle of proportionality seeks to limit damage caused by military operations by requiring  that the effects of the means and methods of warfare must not be disproportionate to the military advantage sought.
What Israel is trying to do is end Hamas, a terror organisation that is a block to peace. The IDF is a trained military force that is subject to the rules of armed conflict and international law. Its soldiers are trained in these ethical matters. Its targeting doctrine and analysis of it is in the public domain and subject to scrutiny. I do not think that Hamas produces joint service publications, but if it did, they would say the opposite. It is there to cause damage and suffering to Israeli civilians and it has no regard, either, to the value of Palestinian lives, whose suffering appears to be acceptable collateral damage to its cause. It is very important that all of us in this House understand those critical principles, and I am sure that the Library will be able to assist hon. Members.

Hannah Bardell: I was pleased to hear the Leader of the House be so unequivocal about Hate Crime Awareness Week. In that vein, can we have a debate on respectful language in politics, particularly when we are discussing vulnerable groups and minorities? The dog-whistle transphobic language and comments from some at the top of her party during its conference were abhorrent. They shame us all. I know that that does not apply to all her colleagues, because I am working actively with some of them on these appalling issues. The Leader of the House and I have had some discussions and I have heard her support for the trans community, but does she understand that our trans siblings are facing unprecedented levels of abuse, and that they are scared? What they need is kindness  and humanity, not senior politicians using them as a punchline.

Penny Mordaunt: I thank the hon. Lady for affording me the opportunity, as a member of this Government, to reassert that we want to ensure that everyone in our society, particularly those who are most vulnerable and most misunderstood as a group, are protected and supported and feel safe. That is part of the reason why the Government undertook the largest survey in the world of LGBT people and their experiences of day-to-day life, and from that survey produced an action plan many of whose elements have already been delivered. This is a priority for the Government. We have a trans MP on our Benches, and we have Members of Parliament whose children or other family members are trans people.

Jason McCartney: The shambolic leadership of Labour-run Kirklees Council has taken the council to the brink of bankruptcy. Its members are blaming everyone but themselves, and local leisure centres, including Colne Valley leisure centre in Slaithwaite, are now under threat of closure. May we have a debate on how failing councils can be held to account for their financial ineptitude so that people do not suffer the loss of vital local services such as leisure centres?

Penny Mordaunt: I am extremely sorry to hear about the situation that my hon. Friend’s constituents are having to endure, and I can sense his frustration at the fact that many of the services they enjoy are now in jeopardy. He will know how to apply for a debate on   this matter, but I would say to his constituents that they will have an opportunity to hold to account the people who are putting those services in jeopardy at next year’s local elections.

Kevin Brennan: May I ask a question about business in the new Session? The Government asked the Culture, Media and Sport Committee to scrutinise and report on the draft Media Bill and were also keen for us to scrutinise the fan-led review of football governance and the White Paper “A sustainable future—reforming club football governance”, but we hear from within Government that there is some pushback on the inclusion of those items in the King’s Speech because they are not divisive enough at this stage, when the Government want to divide rather than unite. Can the Leader of the House assure us that that is not the case, and that the media Bill and the proposals for an independent football regulator will be included in the new legislative programme?

Penny Mordaunt: The hon. Gentleman, who is a very experienced parliamentarian, will know that, because of the rules applying to the King’s Speech, I cannot give that assurance from the Dispatch Box at this time. However, I want to place on record my thanks to him and his colleagues for the work that they have done on these important matters. As he will know, the Government are committed to both of them and, as a supporter of Portsmouth football club, I am particularly committed to the second. He will not have long to wait for the answer to his question.

Andrew Selous: Given that Bernie Ecclestone is now paying £652 million in back taxes, may I, through the Leader of the House, make an autumn statement representation and propose that we use that huge sum to ensure that all the GP surgeries and other health facilities that were committed to in planning applications for large-scale housing estates and have not yet appeared will now be built?

Penny Mordaunt: As my hon. Friend knows, we are going to change local authority planning guidance to raise the profile of primary care facilities when planners are considering how developer contributions and funds from new housing developments are allocated. He has brought this important matter to our attention many times, and I will be happy to write again on his behalf and make a formal representation ahead of the Chancellor’s autumn statement on 22 November.

Marion Fellows: This year’s wear red day for Show Racism the Red Card is tomorrow. I cannot think of a more apt day in the light of recent circumstances. Will the Leader of the House join me in encouraging all Members and folk across the four nations of the UK to take part in this important day and reinforce this year’s theme of “change hearts, change minds, change lives”?

Penny Mordaunt: On behalf of the whole House, I thank the hon. Lady for publicising this important day. For the benefit of Hansard, there were many nods in agreement with what she said. We should all ensure that we take part.

Anna Firth: I thank all Members for their wonderful tributes to my incredible predecessor Sir David Amess. Last Sunday was, of course, a sad day for Southend, and I know their comments will be appreciated by Lady Amess, the family and all Southend residents as we remember Sir David’s incredible dedication and courage not only in campaigning for city status, animals and the Music Man, but in his commitment to women’s health.
In that vein, I invited the brilliant Southend breast cancer charity Lady McAdden to Parliament on Tuesday. Lady McAdden provides the only one-to-one, nurse-led awareness appointments in the country, and it reminded me that, with breast cancer success rates now at nearly 99% when detected early and locally, it is shocking that 30% of women still do not attend their routine mammograms. Will the Leader of the House congratulate Lady McAdden on its work and encourage all women to attend their mammograms? May we have a debate on the future of breast cancer screening?

Penny Mordaunt: I thank my hon. Friend for all the work she is doing to carry on Sir David’s legacy, particularly with the wonderful Music Man project, with which so many Members will be familiar. It goes from strength to strength, and it is wonderful to see how it has developed.
My hon. Friend also deserves credit for the work she has done to raise awareness of the importance of attending screening. We know that early detection hugely increases the chances of defeating cancer, which is why we have invested so much in new diagnostic centres but, of course, people need to be encouraged to attend.
I thank my hon. Friend for the event she put on earlier this week. It is disappointing that props are not allowed in the Chamber, as I understand the event was on knitted bosom day, and there were knitted bosoms available for Members to wear. It is a shame that my hon. Friend was prevented from wearing them in the Chamber today.

Liam Byrne: I join the Leader of the House in her utter condemnation of Hamas’s brutal attack on Israel. It was not what Hannah Arendt once called “the banality of evil”; it was the calculation of evil. That is why it is right that we defend Israel’s right to self-defence.
Like the shadow Leader of the House and colleagues across the House, I am acutely concerned that 2.2 million Palestinians now face humanitarian disaster. The Prime Minister was right to say in his statement:
“We must ensure that humanitarian support urgently reaches civilians in Gaza.”—[Official Report, 16 October 2023; Vol. 738, c. 24.]
What is the best way for us to debate the strategy next week? It seems to many of us in this House that an urgent, negotiated cessation of hostilities, binding on all sides, will be required to ensure that we meet the Prime Minister’s objective. We know that the United States and Egypt are working hard to secure that, so it would be good for us to understand how the UK Government are helping to achieve that objective.

Penny Mordaunt: I thank the right hon. Gentleman for raising this very important matter, and I congratulate him on his recent election as Chair of the Business and Trade Committee.
I repeat what I said earlier: it is incredibly difficult to negotiate a ceasefire with a terrorist organisation but, of course, we want to ensure that innocent civilians are protected and are given the support they need. The UK has a vital role to play in that, not just through diplomatic channels, but through the expertise that Government and our non-governmental organisations have. I am very conscious of the fact that Parliament is about to be prorogued and that Members will want to be kept informed when the House is not sitting, and I shall certainly bear that in mind. He will know how to apply for a debate in the usual way and that Ministers will want to keep the House informed.

Duncan Baker: More than 18 months ago, the National Trust removed a much-loved and vital bridge in Stiffkey that connected the mainland to the marshes at this popular visitor spot on the North Norfolk coast. After much to-ing and fro-ing, it was agreed that on the basis of safety—to ensure that people were not cut off by rising tides—it would be replaced with a new bridge by the National Trust. However, the evidence for the removal of the bridge is still shrouded in mystery today. Despite asking, I, like residents and National Trust members, have been denied sight of the structural surveyors’ report, although we are told that it exists.
Will the Leader of the House find time for a parliamentary debate on the openness and transparency of membership organisations such as the National Trust and whether an organisation designed to protect heritage for the nation should be doing the opposite by prohibiting people from accessing the very spaces they want to enjoy?

Penny Mordaunt: I thank my hon. Friend for raising this important point. Organisations such as the National Trust will be subject to particular obligations, not least those placed on them by the Charity Commission. I can think of no reason why such a report should be withheld, particularly from the members of the National Trust. I will certainly write to the relevant Department to ensure that it has heard his comments today and ask that an official from that Department give my hon. Friend’s office advice about how he can rectify the situation.

Alistair Carmichael: May we have a statement from the Transport Secretary to explain to the House the proposal that the search and rescue helicopter stationed in Shetland in my constituency should have its response times increased from 15 minutes to one hour? The blue-light services of towns and cities would never be treated like that, so why should islanders be treated differently?

Penny Mordaunt: I thank the right hon. Gentleman for raising what sounds like a concerning matter. I shall certainly make sure that the Secretary of State has heard what he has said this morning. I think this is a timely matter, so if the right hon. Gentleman keeps me posted, I shall ensure that the Department is in touch with his office.

Kim Leadbeater: May I associate myself with the comments about Sir David Amess? I have certainly been thinking about his family and friends this week.
Will the Leader of the House agree to an early debate on the serious financial situation confronting local authorities across the country, including Kirklees Council, which covers my constituency? Areas such as mine in West Yorkshire have seen deeper cuts in funding than others. Indeed, the Prime Minister actually boasted that when he was Chancellor he shifted resources to places such as Tunbridge Wells, saying that
“we inherited a bunch of formulas from the Labour party that shoved all the funding into deprived urban areas…that needed to be undone.”
If the funding formula was the same today as it was when Labour left office, Kirklees Council would be in surplus. Instead, it is having to make extremely difficult decisions about the future of valuable local resources, such as Batley sports and tennis centre, Cleckheaton town hall and Claremont House care home in Heckmondwike. I hope that the Leader of the House will agree that this is a matter of urgent concern. Without a fair settlement, we will be storing up enormous problems for the future, which will impact on the health and wellbeing of many of my constituents and those of other hon. Members across the House.

Penny Mordaunt: First, let me say that the hon. Lady will understand more than anyone in this place the comments about Sir David Amess and those sad events. I thank the Jo Cox Foundation, one of the many legacies her sister left, for all the work it is doing on this matter and the tributes it has paid in recent days to Sir David.
The hon. Lady is the second Member today to raise the grave situation at Kirklees Council, which will lead to the potential loss of much-loved public services— I know that leisure services are a particularly great concern there. The Government have always maintained strong funding for local government. In times of great stress, particularly in recent years, we have increased that massively. What we have not done is allow councils over the past 13 years to raise council tax by enormous sums. In the timeframe we have been in government, councils have raised council tax by about 36%, whereas the last Labour Government, over the same period, raised it by 104%. We always have to bear it in mind that there is no such thing as government money—it is taxpayers’ money. We need to protect people, particularly those on fixed incomes, from unlimited increases in the taxes they pay.

Chris Stephens: I refer to my entry in the Register of Members’ Financial Interests, as I have been contacted in my capacity as chair of the Public and Commercial Services Union parliamentary group on behalf of low-paid, outsourced facilities management staff across 10 different Government sites. As a result of a retendering process, I am advised that those workers will shift from Mitie to either ISS or OCS Group. That means workers will face seven weeks without a wage because of changing pay dates. I am sure the Leader of the House will understand the impact that will have on universal credit, for example, so can we have a debate in Government time about the outsourcing of facilities management workers? In the light of prorogation, will the Leader of the House contact Cabinet Office colleagues so that we can pause the arrangements and there can be a meeting with the trade union, ensuring those workers are not left in financial hardship?

Penny Mordaunt: The hon. Gentleman is right that we do not have a date for the next Cabinet Office questions because of the prorogation of Parliament, so I will make sure that the Minister for the Cabinet Office has heard what the hon. Gentleman has said.

Stephen Doughty: I associate myself with the remarks made by the shadow Leader of the House, my hon. Friend the Member for Manchester Central (Lucy Powell). Many constituents in Cardiff South and Penarth have expressed their horror and shock at the loss of innocent life in Israel and Gaza, their revulsion at Hamas, but also the importance of international law and humanitarian access and principles being upheld.
We have seen a shocking rise in antisemitism and Islamophobic incidents in recent days and weeks. It is National Hate Crime Awareness Week and we heard about Show Racism The Red Card yesterday, so can we have a debate in Government time on the importance of tackling hate crime on the basis of race and religion, particularly the important work that faith communities are doing to respond to those issues and to increase cohesion? We have had terrible examples of these issues in the past in my own community, but the response of faith communities has always been amazing. Could we have a chance to praise that work and to share good practice?

Penny Mordaunt: I thank the hon. Gentleman for adding his voice to the many who have spoken about their concerns and about the desire to ensure all communities are secure, protected and feel confident going about their daily lives. He is right that we need to point to good practice and the tremendous number of organisations who are doing wonderful work across communities, ensuring people are brought together and stand against those individuals who seek to divide and spread hate. If he were to apply for a debate, I am sure it would be well attended.

Patricia Gibson: As we approach Remembrance Sunday, we can all agree that veterans and their families who have experienced pain and loss as a result of their service in the armed forces are rightly compensated. Yet under current arrangements, 150,000 armed forces veterans and their families, 12,000 of whom are in Scotland, find their welfare benefits are means tested as their compensation payments are treated as income. Will the Leader of the House make a statement setting out her support for the British Legion’s credit their service campaign, which asks that no member of the armed forces community has their compensation treated as income when undergoing means testing for welfare benefits, as is already the case with civil service awards?

Penny Mordaunt: The hon. Lady raises an important point. The UK Government take these matters extremely seriously, which is why we have compensated members of the armed forces who are resident in Scotland and who are serving for the additional tax that they have to pay under the SNP Government. Large parts of welfare policy are devolved to the Scottish Government, but given that we are about to prorogue Parliament, I shall make sure that colleagues at the Department for Work and Pensions and the Ministry of Defence have heard  the hon. Lady’s remarks. The next Department for Work and Pensions questions are scheduled for 30 October, but Defence questions are yet to be scheduled, so I will write to both Departments on her behalf.

Jeff Smith: We have all been horrified and devastated by the Hamas attacks on innocent Israeli civilians and by the suffering of innocent Palestinian civilians facing an unfolding humanitarian crisis. We urgently need the release of the Israeli hostages and we need the opening of viable and sufficient humanitarian and medical relief corridors.
Like a number of Members, I have constituents stranded in Gaza. They are in a terrible situation and it can be very difficult for us to know how to get help to them. I trust that we will get regular updates on the situation next week. Can they include specifically any updates on how we can best engage with the Government and other agencies to get help for our constituents? Further to what the Leader of the House said earlier, will she make arrangements for regular virtual updates as appropriate while we are in prorogation?

Penny Mordaunt: I am sorry to hear about the situation that some of the hon. Gentleman’s constituents are facing. Those who have worked with Foreign Office consular services will know that they are incredibly diligent and work very hard to ensure that people are kept informed about things, and also that cases can be resolved. I will certainly undertake to ensure that, before Parliament is prorogued, all Members of this House have very clear information about where they can get updates. I am very conscious that some Members may not yet be aware if a constituent is in this situation, and we want to ensure that that constituent can get help and assistance immediately it is needed. I undertake that that will happen, and I have already had a number of conversations with colleagues in Government about how we can ensure that that is done.

Alan Brown: I wish to return to the infected blood scandal and the reality that victims are still waiting for compensation despite having been infected as long ago as the 1970s and 1980s. Sadly, it is also estimated that every four days a victim dies without receiving justice. The Scottish Government have set up the Scottish infected blood scheme. Ireland has been paying out since 1995. Given the fact that there are further delays in the infected blood inquiry, as other Members have raised, can the Leader of the House confirm that the Government will do the right thing and bring forward a compensation framework before there is a risk of a general election kicking everything even further into the long grass?

Penny Mordaunt: I thank the hon. Gentleman for raising this important matter. I just want to make sure that people are not misunderstanding what he has said. The schemes that he mentions are not compensation schemes. I was the Paymaster General who brought in parity across the four nations for support schemes, so this is not compensation for the injustice that people have suffered; it is ongoing support for what they need. There is now parity across the four nations, and I am very pleased that we secured an agreement that, if there is any change to support schemes, they are done together with that parity across the four nations of the United  Kingdom—that is a very important principle. What we also want to ensure happens is that people are compensated for the layer upon layer of injustice that they have suffered. I refer the hon. Gentleman to the answer that I gave a moment ago to the right hon. Member for Kingston upon Hull North (Dame Diana Johnson), who chairs the all-party group on Haemophilia and Contaminated Blood, and I will make sure that the Paymaster General has heard that this House would like an update.

Andrew Slaughter: Will the Leader of the House ask ministerial colleagues to report to the House on breaches of international law during the war in Gaza? Targeting, displacement and collective punishment of civilians are war crimes whoever commits them. This country has a proud record of upholding international law and bringing to justice those who break it. Should we not continue to do that whether in Gaza, Ukraine or other conflicts?

Penny Mordaunt: I take these matters very seriously. Indeed, when I was International Development Secretary it was because of the regard that nations had for international humanitarian law that I was unable to unblock Hodeidah port and get aid into Yemen. These are very important principles and we must ensure that they are upheld. We as a nation must ensure that people understand that we place them at the heart of everything that we do.
What I would say to the hon. Gentleman, though, is that we need to be led by the facts in this case, and saying that Israel is collectively punishing Palestinians is quite wrong. In an earlier answer I gave quite detailed information about the framework that Israeli defence forces adhere to and the training that they undergo. He can look up previous conflicts and information that has been put out about how the Israeli defence forces conduct themselves, the care that is taken when undergoing targeting boards and the scrutiny that is applied to that, and the legal frameworks covering those things.
Hamas does not have the equivalent, and it is important that the language that we use in this place is correct and factual. There are extremely serious consequences in this country and across the middle east region of promoting information that is not correct. That is incredibly important. I know that the House of Commons Library will take its responsibilities seriously. This is a legitimate action that Israel is taking to defend its own security and defeat a terrorist organisation. We and other nations have stressed that that must be done according to international law and the principles that I set out earlier. The hon. Member has the Government’s assurance that we will not waver from that view.

Christine Jardine: Over the recess, I met representatives of Dementia UK, a fantastic charity that is providing research, support and much needed hope for people suffering from this dreadful condition. It is currently working to provide more of its specialist admiral nurses in primary care settings, including in my city of Edinburgh, where there are 8,500 people currently coping with dementia. I was unable to put the question directly at questions this week, but could we please have a statement on the progress that the Government  are making on dementia care under the major conditions strategy and their Dame Barbara Windsor mission, particularly with an emphasis on training and support for specialist dementia nurses?

Penny Mordaunt: I thank the hon. Lady for raising that incredibly important point and highlighting the work that that organisation does on research and, critically, care. She will know that it has been a priority for the Government under successive Administrations to ensure that we are having the current breakthroughs on new drugs, with the second drug that is able to combat this terrible disease, and that we have the best possible care across the UK. I shall ensure that the Secretary of State has heard of her desire to have an update on these very important missions.

Steven Bonnar: My constituent Callum from Coatbridge is a firefighter based in a station on the outskirts of Glasgow. With the support of his watch commander, he recently applied to the Government’s access to work scheme for the additional support that he is rightly entitled to, but after months of waiting he has still heard nothing. I am sure that the Leader of the House, like me, supports the aim of the access to work scheme to help people to remain in the workplace, so can we have a debate on the Floor of the House to ensure that people who are desperate to work are not being impacted once again by the intransigence of the Government?

Penny Mordaunt: I am sorry to hear about the difficulty that the hon. Gentleman’s constituent has had in accessing the scheme. The hon. Gentleman will know that through the health and work plan, of which access to work was a large part, we have managed to get an additional 1 million people with disabilities into work. It has been a priority for the Government. If the Scottish Government were concerned that we were not moving fast enough, they could have taken up the offer of administering welfare and disability benefits and schemes themselves when that was offered by the UK Government, but they did not. The access to work scheme is vital. If he gives me the correspondence that he has had with the Department and the details of the case, I will follow it up this afternoon, because his constituent needs to get access to that money, and I will do everything that I can to help him to ensure that that happens.

Jim Shannon: The three earthquakes in Afghanistan last week killed at least 2,445 people and left thousands of families homeless. Despite that, the situation has received little international attention, but with the ongoing war in Ukraine and the conflict and murders in Israel, we understand why. We also know that humanitarian aid often does not reach minority or rural communities, particularly in Afghanistan. The Leader of the House always responds positively—we all appreciate that—so will she ask the relevant Minister to highlight the UK response to the disaster and the steps taken to ensure that humanitarian aid reaches all those in need, who are not forgotten by us in this House?

Penny Mordaunt: On the behalf of the whole House, I thank the hon. Gentleman for shining a spotlight on the plight of individuals who may not have received either media coverage or debates in this place. He enables  us to get on record the fact that just because that has not happened, does not mean they are not at the forefront of our minds. What has happened in Afghanistan is a terrible tragedy, and I know that the Development Minister has been focused on ensuring that we do all we can to alleviate suffering. It has been one of the Foreign, Commonwealth and Development Office’s largest bilateral aid programmes this financial year and will remain so, I think, for some time. I will ensure that the Minister is alive to the fact that this House would appreciate an update, and if that cannot happen on the Floor of the House due to Parliament being prorogued, I shall ensure that the Commons Library has the updated information.

Point of Order

Bob Blackman: On a point of order, Madam Deputy Speaker. Unfortunately, the Chair of the Liaison Committee, my hon. Friend the Member for Harwich and North Essex (Sir Bernard Jenkin), is not able to be here, nor is the Chair of the Levelling Up, Housing and Communities Committee, who is on a Select Committee visit to Canada. The Levelling Up, Housing and Communities Committee published a report on the private rented sector, with a reply expected by April this year. The Secretary of State promised that that reply would be with us before the Second Reading of the Renters (Reform) Bill. The Leader of the House has obviously announced the business for Monday, which includes that Second Reading, but we still have not had any reply from the Government to the Select Committee’s recommendations, including proposals for changes to the Bill. That will not help the House when it is considering the Second Reading.

Rosie Winterton: I thank the hon. Gentleman for giving me notice of his point of order, but if questions relate to business, they should be raised during business questions, because it is not fair on the Leader of the House if people prolong business questions with points of order. I believe that the Leader of the House is happy to respond, but I want to make it clear that the hon. Gentleman perhaps should have raised this matter during business questions itself.

Penny Mordaunt: Further to that point of order, Madam Deputy Speaker. I have heard what the hon. Gentleman has said on behalf of his colleagues, and I will make sure that it is heard by the Department. I will follow that up this afternoon.

Rosie Winterton: I thank the Leader of the House for responding to the point of order, and we will now move on.

Backbench Business

Birth Trauma

Theo Clarke: I beg to move,
That this House notes that many women across the UK experience birth trauma; and calls on the Government to take steps to support women experiencing birth trauma.
I am honoured to lead the first debate in the history of the UK Parliament on birth trauma, which coincides with Baby Loss Awareness Week. Today, I am calling on the Government to do more to help mothers who have suffered birth trauma.
I start by thanking the many brave women from across the UK who contacted me, after I shared my own story, to share their personal experiences of birth trauma ahead of today’s debate. I have been overwhelmed by the response to my new campaign on this issue. I am taking the time to read and respond to every single one of you, and reviewing them has been a harrowing experience. Thank you for being so courageous in sharing your stories with me. You are the reason I am here today, to be your advocate in Parliament. I know that a number of mums are here to watch the debate today, and I welcome them to the House.
I thank a number of organisations, including the Birth Trauma Association and MASIC, for all their support. My campaign began several months ago, when, following my return from maternity leave, I decided to share my own story of birth trauma. This is the first time I have ever spoken about it in Parliament, and it is probably the most personal speech I will ever give as an MP.
Last year, I had a very traumatic birth at my local hospital in Staffordshire. I had expected to have that first hour with my beautiful daughter, and imagined her magically crawling up my chest to start breastfeeding. Instead, after 40 difficult hours of labour, I began bleeding very heavily after delivery. I was separated from my baby and rushed into the emergency room for surgery. I remember the trolley bumping into the walls, the medical staff taking me into theatre, and being slid on to the operating table. I spent over two hours awake, without a general anaesthetic. I could hear them talking about me, and obviously it was not looking good. It was the most terrifying experience of my life.

Andrea Leadsom: I thank my hon. Friend for addressing what is just about the most difficult subject for any woman to have to cover. I absolutely and heartily applaud her determination to raise the issue so that other mums who have had such a terrible experience can also take some comfort from it. She is doing an immensely brave thing and has the support of Members right across the House. I thank her.

Theo Clarke: I thank my right hon. Friend for her intervention and for her excellent work on the start for life programme to ensure that children under five get the help that they need.
It was the most terrifying experience of my life— I genuinely thought that I was going to die—so I put on the record my immense thanks to the fantastic NHS team at Royal Stoke University Hospital, who carried  out my surgery, and to the midwives who were with me during labour. I thank in particular my surgeon Nitish, my midwives Michelle and Stacey, my health visitor Chris, my mental health advocate Judith, and Nicole at the perineal clinic. However, the entire experience has also completely opened my eyes to challenges in post-natal care in this country.
I remember being wheeled into the recovery ward after surgery, where I encountered a nurse who had not read her notes and assumed that I had had a C-section. I was then moved to a side room, where I was hooked up to a catheter and a drip, and was lying in bed next to my baby, who was screaming in her cot. I could not pick her up. I pressed the call button for help, and a lady came in and said, “Not my baby; not my problem,” and left me there. That is unacceptable behaviour, especially when you are extremely vulnerable. I have subsequently met the hospital trust chief executive and the chief nurse, and I appreciate their apology and commitment to providing quality, safe care to women in Stafford going forward.
I spent nearly a week in hospital. One of my main reflections was the lack of aftercare for mothers. There is so much focus on the baby that we sometimes seem to forget that the mum has had a traumatic experience and needs care, too. I had never heard of birth injuries before. I later discovered that during childbirth I had suffered from what is known as a third-degree tear, when the baby stretches the vagina and rips the muscle in the back passage called the anal sphincter, which it is vital to repair. It is important to say that, although many women will have no issues in childbirth, some will, like me, be unlucky and have a third or fourth-degree tear, which occurs in about three in 100 vaginal births. I now know that around 20,000 women a year in the UK suffer from birth injuries. The consequences of an untreated obstetric tear can include urinary and faecal incontinence, as well as ongoing pain, so it is clear that we must do more to help those women.
On my return from maternity leave, I contacted those at the Birth Trauma Association, who are here with us today, and asked them to bring some mums to visit me in Parliament. I discovered that there is huge disparity across the UK in care for mothers who have experienced birth trauma. I was genuinely shocked at some of the stories those mums shared with me. For example, Gill Castle suffered from a fourth-degree tear and now has a stoma bag, and she had to give up her job as a police officer. She has since become an amazing campaigner on birth injuries, and I congratulate her on just becoming the first person with a stoma bag to solo swim the English channel.
It was so upsetting to hear their stories following that meeting, including sad examples of babies who had died and examples of medical negligence. That is why I decided to launch a new all-party parliamentary group on birth trauma with my Labour co-chair, the hon. Member for Canterbury (Rosie Duffield), who I am delighted is here today supporting the debate. Our APPG is cross-party, and we are so pleased that many colleagues from across the House have joined us to provide support. I welcome NHS England’s commitment to addressing these issues and the fact that it has now set out a three-year delivery plan for maternity and neonatal services, published in March, but it is clear that we still need to do more to improve post-natal care.
Birth trauma is caused by traumatic events or complications in birth. It is a term that can apply to those who experience symptoms of psychological distress after childbirth or physical injuries sustained during delivery. Those can include surgical procedures such as a sudden emergency requiring a caesarean section or a long and very painful labour in a severe state of pain for many hours.

Jim Shannon: I thank the hon. Lady for her courage in sharing her personal story with everyone in the Chamber and those further afield. One of my staff members had an emergency C-section. It started before she was under anaesthetic, and she was unaware it was coming. The trauma of it was very real, and it is clear that she should have been offered help to come to terms with it. She left hospital with a beautiful baby, yes, but she also left with a scar and a memory of traumatic events that she could not process because she did not know what was happening, and it all came upon her very quickly. Does the hon. Lady agree that in such scenarios, counselling and help should be offered at the beginning and should be accessible for all?

Theo Clarke: I thank the hon. Member, and I absolutely agree. If he will bear with me for a few more minutes, I will get on to that later in my speech.
I was talking about examples of birth trauma, which can also include a premature or very ill baby, having a difficult forceps birth, or a post-partum haemorrhage with severe loss of blood. Women have told me that they felt fearful that they or their baby might die. The traumatic event can be exacerbated by unkind or even neglectful care, or when women who feel physically or emotionally damaged after a traumatic birth are expected to look after their baby without any help.
Research shows that 4% to 5% of women will develop post-traumatic stress disorder after birth, which translates into about 30,000 women a year in the UK. The diagnosis of PTSD does not just relate to mothers but can also include fathers who have been present at their partner’s birth. Many of them have told me that they were kept in the dark about what was happening to their partner and baby. Symptoms of PTSD can include flashbacks or nightmares; negative alterations in mood such as guilt, sadness or self-blame; and a feeling of being constantly anxious and on high alert.
Birth trauma is obviously compounded by the stress of looking after a newborn baby, including months of sleep deprivation. Mothers have written to me to say that medical procedures that remind them of birth, such as a cervical smear test, can induce feelings of terror. Others became so fearful of their baby coming to harm that they refused to leave the house or let anyone else hold their baby. In many cases, their relationship with their partner has deteriorated because the woman has become so distressed. Women have told me that they found it impossible to return to work due to flashbacks or because they have physical injuries that make it impossible to do their job. Psychological, as well as physical, birth trauma also occurs when the mother is separated from her baby immediately after birth, which is what happened to me, and when they are poorly treated by healthcare professionals.
I was extremely lucky that I was treated by a specialist perinatal mental health team called the Lotus Service in Staffordshire, which included trauma-focused cognitive  behavioural therapy and eye movement desensitisation and reprocessing, known as EMDR, in addition to attending a specialist perineal clinic for my tear. I welcome the fact that NHS England is setting up regional perinatal mental health services, but I am afraid that it is still patchy, and many women still face long waiting lists for therapy. In 2014, fewer than 15% of localities provided specialist perinatal mental health services for women with complex or severe conditions at the full level recommended by National Institute for Health and Care Excellence guidance, and I am afraid to say that 40% provided no service at all.
Clearly, we must end the postcode lottery that mothers in the UK currently face. It is unacceptable to me that a mother can receive a different level of care just because of where she lives, so today I call on the Government to ensure that perinatal mental health services are available to all mums across the UK.
I turn now to post-partum psychosis, which is a serious mental health illness that can affect mothers after they have had their baby. Tragically, it affects around one in 500 mothers after giving birth. Post-partum psychosis is very different from what is sometimes called the baby blues, which is more about mild mood changes post-birth: this is a serious mental illness that is treated as a medical emergency. Symptoms can range from hallucinations to manic moods and delusions, and it can sometimes take up to a year to recover. In my constituency of Stafford, we are privileged to have an amazing parent and baby unit at St George’s Hospital, which I recently visited. It is a specialist facility that aims to provide in-patient mental health services for women experiencing psychological and emotional difficulties specifically related to the latter stages of childbirth and early motherhood.
Next, I want to highlight the recent reports into maternity care at Morecambe Bay, Shrewsbury and Telford, East Kent and Nottingham, which have all identified problems in birth that arise from inadequate care. Sadly, those reports identified problems such as understaffing, poor team working or a culture of blame, which all contributed to the very sad and avoidable deaths and injuries of mothers and babies. We also know that a difficult birth is much less likely to lead to a woman developing trauma symptoms if the staff treat her with kindness and dignity, make sure that consent is obtained for procedures, respect her wishes for pain relief, and display sympathy when she is clearly distressed.
I have spent the past few months meeting with experts in the field, including the Royal College of Obstetricians and Gynaecologists, the Birth Trauma Association, the MASIC Foundation and the Maternal Mental Health Alliance. Following this, I partnered with Mumsnet—the online forum for mothers—to conduct a national birth trauma survey, given the lack of data. Our survey received 1,042 responses. The key results showed that 53% experienced physical trauma; 71% experienced psychological or emotional trauma; 72% said that it took more than a year to resolve; 84% who experienced tears said that they did not receive information about birth injuries ahead of time; and 32% experienced  notes not being passed on between shifts. These results are shocking, and we shared them recently at our  first meeting of the all-party parliamentary group on birth trauma.
I was very grateful that Dr Ranee Thakar, president of the royal college, came to that meeting to talk to us about her initiatives, including on obstetric anal sphincter injuries—known as OASI—which, as I have already mentioned from my personal experience, are third and fourth-degree tears. Long-term consequences can include chronic pain, sexual dysfunction, and difficulty or inability to control the bladder, bowels or passing of wind, and can significantly affect mental health and people’s ability to carry out everyday activities. We need to break the taboo by talking about this, and that is what I am trying to do today. Childbirth has been identified as a key risk factor for the development of pelvic floor dysfunction later in life, with one in 12 women having a pelvic organ prolapse.
To reduce the likelihood of birth injuries, UK experts led by the royal college created the OASI care bundle, which has already been rolled out in 19 new maternity units since 2019. That care bundle has been significant in reducing birth injuries by 20%, so today I call on the Government to roll it out across NHS England to all hospital trusts. I also put on record my thanks to Mr Speaker for extending my proxy vote after my maternity leave, in order for me to recover from my own birth injury. This new system of remote voting will make a huge difference to MPs who are new mothers or have had to undergo major surgery, as I did.
Sadly, ahead of today’s debate I have been inundated with hundreds of emails and letters from mothers who have experienced birth trauma. I thank each of those, and in some cases the partner, who have taken the time to write. I know how difficult and painful it is to talk about this. With their consent, I will briefly share some stories that I believe powerfully highlight the issue.
One mother, who gave birth in Leicester General Hospital, writes:
“I delivered my son naturally and without intervention, but I did suffer a third-degree tear. This wasn’t really explained to me at the time, other than to tell me that I needed stitches. It was only afterwards, when I received a copy of the consent form, that I realised exactly what the surgery had been for.”
Another mother writes:
“Labour was progressing well, then I started to…tear, so an episiotomy was performed. But I had torn all the way to the back, I was taken into theatre for repair…which took nearly 2 hours. I lost about 1 litre of blood… Currently I experience pain and bleeding after bowel movements, pain during sex”
and, as we can imagine, a
“smear test several months ago was agonising”.
She said she had been
“experiencing nightmares, awful intrusive thoughts and panic attacks, all concerning leaving or being separated from my son”,
and she was referred to her GP for post-traumatic stress disorder.
A mum called Stacy says:
“I was told I’d either need forceps or a C section so would be taken to theatre. I couldn’t read the form I was so out of it and I remember my signature sliding down the page”.
Another writes:
“I suffered birth trauma, feeding issues, bad medical advice, poor mental advice, long term sleep deprivation”,
and even PTSD was triggered in her husband.
Sadly, there have also been examples of inequalities in treatment among ethnic minority groups. One mother explains that
“the nurse did not spot my haemorrhage due to the colour of my skin. There needs to be more diversity training, as the medical professionals fail to recognise symptoms in non-white patients”.
Finally, an NHS doctor who served as an obstetrician wrote to me to say:
“Occasionally it was dads who were traumatised. Watching your partner experience a major obstetric haemorrhage and literally being left holding the baby whilst she is being wheeled away from you into the operating theatre was…a distressing experience and as time went by the dads were sometimes left wondering if they might be bringing up the baby as a single parent. Everyone was busy with their wife in theatre and no one came to speak to them for quite some time”.
Unfortunately, none of these are isolated incidences—they occur all too frequently—so the Government must take action to improve the experiences of women who have traumatic births.
I welcome the fact that the Department of Health and Social Care published its 10-year women’s health strategy for England last year. I also welcome the appointment of Professor Dame Lesley Regan as the Government’s first ever women’s health ambassador for England, and I look forward to meeting her in a few weeks’ time. However, on reviewing the Government’s strategy, I was surprised to find the mention of birth trauma only once in the entire document, which was in the context of a call for evidence for the public inquiry. Given that the public in their response to the Government’s strategy included a request for birth trauma, it is now essential that this is delivered in any future updates to the women’s health strategy. So today I am calling on the Government to add birth trauma to the women’s health strategy in a meaningful way.
Lastly, I want to touch on staffing. We know that our brilliant NHS workforce is essential to ensuring safer and more equitable maternity services. This has been recognised in both the Ockenden and the East Kent reports. We know that safe staffing levels are essential to the provision of safe maternity care, and we also know that workforce recruitment remains a priority concern. I note that NHS England’s long-term workforce plan has set out commitments to support our maternity and neonatal workforce, but unfortunately staffing gaps remain, with an 11% vacancy rate.
In conclusion, it is so clear to me that so much more needs to be done to support women who experience traumatic births. Today I call on the Government to add birth trauma to the women’s health strategy; recruit more midwives; ensure perinatal mental health services are available across the UK; provide appropriate and mandatory training for midwives with a focus on both mental and physical health; ensure that the post-natal six-week check with their GP is provided to all mothers, and will include separate questions on both the mother’s physical health and her mental health in relation to the baby; improve our continuity of care so there is better communication between secondary and primary health care, including explicit pathways for women in need of support; provide post-birth services nationally, such as birth reflections, to give mothers a safe space to speak about their experiences in childbirth; roll out the obstetric anal sphincter injury care bundle to all hospital trusts in England to reduce the risk of injuries in childbirth; provide better support for partners and fathers; and, finally, have better education for women on their birth choices and on risks in order to ensure informed consent.
Let me thank all the birth trauma organisations and the mothers who have contributed to this campaign. I really hope that the Government will listen to my plea today, and ensure that women who suffer from birth trauma will now receive additional support.

Rosie Winterton: I congratulate the hon. Lady on her opening speech, which I am sure was very difficult to make but was extremely brave. I will certainly pass on her thanks to Mr Speaker regarding her proxy vote.

Rosie Duffield: First, I wish to thank my lovely hon. Friend the Member for Stafford (Theo Clarke) for securing this debate, for setting up the all-party parliamentary group for birth trauma, for her brilliant speech and bravery, and for generally allowing me to ride chaotically on her incredibly organised coattails.
What is birth trauma? The Birth Trauma Association describes it as
“a broad term applied to those who experience symptoms of psychological distress after childbirth. It includes those whose symptoms qualify for a diagnosis of post-traumatic stress disorder.”
That term certainly applies to the many women who took part in our recent Mumsnet birth trauma survey, which included some statistics that should be of concern to all health professionals, and some shocking stories of women’s experiences. It also certainly applies to those women in east Kent whose experiences contributed to the damning Kirkup review, which was released a year ago in October 2022.
Women who had every right to expect safe and professional care during their pregnancies and labour were badly let down by our health trust, often with life- changing consequences. The poor, sub-standard maternity care received by many families over an 11-year period made for extremely harrowing reading, and I take this opportunity to thank Dr Kirkup and his team for their painstaking work, and for their sensitive and caring approach to the women and families over the course of their investigation. I know that they continue to make themselves available to anyone who may need them, which is in stark contrast to the scandalous way in which those families were often treated at the height of their trauma, and as they struggled to come to terms with what they had been through.
No matter what analysis of each individual case of birth trauma or the findings of reports conclude, one basic requirement should be unchanged in the hospital experience of every single patient: care. Kindness, good manners, information, listening to women—those are not things that should be altered or affected in any way by medical circumstance or emergency. Are such things not in fact even more vital when a panicked or distressed family are faced with a traumatic situation? The way that my hon. Friend was spoken to after her unexpectedly difficult birth—I should not need to stand in this place and explain that it was unacceptable.
For my constituents in East Kent Hospitals University NHS Foundation Trust, which is chronically short-staffed and plagued by low morale and a lack of equipment, those factors definitely contributed to some of those terrible experiences. Basic patient care standards should always apply, and essential staff, no matter how lowly their place in the chain of command, must always be  afforded respect by those in authority so that they feel supported and, crucially, are able to raise concerns without the real fear of repercussions.
During the Kirkup inquiry, much of my team’s work was speaking to staff who wished to be contributors but were extremely afraid of speaking out. One midwife went to great lengths to remain anonymous, even buying a burner phone in order to call me in my office. She was very upset and nervous but helped me a great deal by providing background information. Why should a whistle- blower have to be so afraid when her testimony could help to improve standards and practices in our NHS?
The Minister recently attended a discussion with some of the families and mothers who contributed to the Kirkup review in my constituency. I know they felt that she listened and had direct contact, which was so important to them. Their experiences should make every Member here, and every member of East Kent Hospitals University Foundation Trust, determined to improve every aspect of maternal care in our region.
In his “Reading the signals” report, the overriding and most important point that Dr Kirkup stressed was simply, “Listen to women.” Yet those I am still in contact with, although grateful for the acknowledgement and involvement of the Minister and our trust’s new CEO, Tracey Fletcher, still do not yet have faith that services have improved dramatically. Whenever family or my staff members use maternity services in East Kent, I tell them to ensure that their relationship to their MP is mentioned. That should not be something I have to do in order to feel that they might be safe and looked after.
I want to make time to read out direct comments from some of the mothers and families involved in that inquiry, and especially from my former constituent, Helen Gittos. I thank her for her tenacity, her courage, and for continuing to raise issues with me on behalf of those affected. I will end by reading out Helen’s thoughts, emailed to me late last night, as I think that her voice in this debate is far more important than mine. She says:
“Some of the strongest comments tonight have come from those families who are caring for very disabled children. It was Amie Taylor who said this, ‘Personally, I would love them to understand that this has had a profound effect on us all in more ways than seems to have been acknowledged by the Trust, or maybe even the report, from somebody who had a baby with a brain injury following sub-standard care. We are faced with ongoing medical issues and the strain mentally, physically, emotionally, financially, and what may be the other side of this, hasn’t been acknowledged. The impact this has had on our careers, family dynamics, social life—every element of our lives were affected. PTSD, anxiety, depression. I am pretty sure all the families have experience in one degree or another of this.’”

Jane Stevenson: My constituent, Tracie Reynolds, lost her daughter Trinity in New Cross Hospital in Wolverhampton 20 years ago, and she has been campaigning on maternity services and indeed has met the Minister. Let me put on record my thanks to my hon. Friend the Member for Stafford (Theo Clarke) and the hon. Member for Canterbury (Rosie Duffield) for bringing forward this debate. I know so many mothers who have struggled, and I wanted to place on record the thanks of my constituent, Tracie, in memory of Trinity and all the babies who sadly are not here. My hon. Friend and the hon. Lady have done an immense service to so many people by bringing forward this debate.

Rosie Duffield: I thank the hon. Lady very much.
Helen goes on to say:
“Staff in the Trust and women with very recent experience say that there has been no real change. One woman said on the Facebook Support Group tonight ‘Having had my 6th baby at William Harvey Hospital this August I can say very little has changed 1 year on’.
What we have seen so far is action plans but not actions—exactly the kind of checklist, tick-box exercise Bill Kirkup said doesn’t work. I and others do not think the core messages of Reading the Signals have been understand—let alone acted upon. Clinical leadership is absent. New Head of Midwifery and her Deputy seem excellent but the doctors are just not present—they are not writing the action plans, not attending the Reading the Signals Oversight Group meetings, just really absent. How can the Government say that they accept the findings of the report when NHS Resolution—who act on their behalf—are not accepting the findings?”
The Minister and I heard that when we spoke directly with those families. Helen continues:
“How can the Trust say that they are concerned about patient safety when lawyers acting on their behalf continue to behave appallingly at inquests? In the case of Archie Batten they tried to argue he was stillborn and therefore there should be no inquest. In the case of Maya Siek in September, they argued there was no need for it to be an Article 2 inquest.”
That comes up time and again, as the Minister knows. Those women want the law to be changed so that stillborn births have to have an inquest.
Helen says:
“One family involved in this said on the Facebook group tonight: ‘Personally, I would love them to understand that this has had a profound effect on us all in more ways than seems to have been acknowledged by the Trust, or maybe even the report”.
I earlier mentioned that her child had a brain injury. Helen continues:
“Another simply said this: ‘This last year has caused so much turmoil for so many I hope that comes out somewhere.’ I think that really captures the experience of so many people involved—and that turmoil has been partly because people’s experiences of engagement with the Trust continue to be so problematic. But I think the Kirkup report provides us with a plan. And that rather than get side-tracked into an expensive, time-consuming public enquiry, we should all put our collective effort into enacting its recommendations. If we did, things would get better.”
I thank the House for its indulgence; this is a really upsetting debate.

Douglas Ross: It is an honour to follow the hon. Member for Canterbury (Rosie Duffield). I congratulate my hon. Friend the Member for Stafford (Theo Clarke) on how she introduced this debate and her bravery and courage in articulating her own case and also those of many others in the Chamber today and watching at home. My hon. Friend mentioned some of the figures that came out of the Mumsnet survey into birth trauma, and one of the most stark for me was that 79% of women have experienced birth trauma. At what should be and often is the happiest time in our lives as parents, to go through that trauma is unacceptable. For so many to do that is incredible.
Another issue that I thought was important was the number who felt they were not listened to, which comes up time and time again. One says:
“I know 100% I was not listened to, because my husband was there begging for them to listen, and he was refused point-blank and told to go away, because I was just ‘freaking out because I was hormonal and pregnant’.”
That kind of care is unacceptable. The fact that so many women at that vulnerable stage feel that they are not listened to is shameful. I was particularly reminded of that when I saw and heard the spontaneous applause and ovation following my hon. Friend’s speech. I now feel that the women in the Gallery and the mums are being listened to. They are being listened to in our Chamber today. It is a shame that this is the first time this matter has been debated in our Parliament, but the work of my hon. Friend and the hon. Member for Canterbury together across parties has ensured we can have a debate today. That means, I hope, that more and more women will feel listened to on this important subject.
I will speak about birth trauma from a local constituency point of view and in the context of the downgrading of our maternity hospital at Dr Gray’s in Elgin. I have raised it many times. It is certainly not the levels of trauma that my hon. Friend the Member for Stafford has experienced and articulated, but it is a trauma that too many of my constituents go through. I will articulate some of their cases. In 2018, Dr Gray’s maternity unit was given a temporary 12-month downgrade. Here we are in October 2023, and I am still as the MP for Moray raising concerns that we do not have a full consultant-led maternity unit back up and running. It means that any woman who is not on a green pathway has to travel to either Aberdeen or Inverness in the most trying of circumstances to give birth.
I will briefly mention our own experience. We have two lovely boys: Alistair and James. Alistair was born in Dr Gray’s. He was on a green pathway and everything was fine. The care at Dr Gray’s was exceptional. Our second son, James, was born in 2021, and he and my wife were on a green pathway right up until the moment she went into labour. We went in to see the midwife in Elgin just as the labour was starting, and she just was not comfortable; there was something I picked up, and I was not being told everything. They just were not 100% happy, so they said, “Go up to Dr Gray’s and just see how things are progressing.” I knew if anything went wrong, we would be going to Aberdeen, because I had been dealing with far too many of these cases as the MP. I always felt that, luckily, I would not experience that, because Krystle had been on the green pathway with both Alistair and James.
Things clearly were not right, and we were told at one point that James’s heart rate was dipping. As soon as you hear that as a parent, you start to worry. I am not medically trained, but when told that the heart rate of a baby who is about to be born is dipping, and that there is worry about contractions, parents immediately start to worry. We were reassured by the teams in Dr Gray’s, but then we were told that we would have to transfer, which was my nightmare. I had been raising questions about this issue in Holyrood with Scottish Government Ministers, who responded very well, and I had raised it here. The journey from Elgin to Aberdeen is 70 miles on a not particularly good road. I remember being told that we would do an emergency transfer: Krystle would be put in an ambulance and I would go in the car through to Aberdeen.
I do not get particularly emotional, but that walk with my wife on a trolley from the maternity suite in Dr Gray’s, where I hoped our second son would be born, through the hospital to an ambulance was one of the worst I have ever experienced in my life, because I knew those were the last few minutes I would be with  my wife before she was put in the back of an ambulance to travel separately from me to Aberdeen. She got strapped in. I cannot imagine what it is like having contractions strapped on your back in the back of an ambulance, facing a 90-minute journey through to a hospital to give birth, knowing that the child inside has problems with a dipping heart rate. But I had to leave her; I could not be with her at her most vulnerable time. She was put in the back of the ambulance, and I was told to go straight away, because the ambulance obviously had blue lights and could get to Aberdeen far quicker than me.
I left with the doors closed, got in the car and I kept looking in my rear-view mirror, thinking, “Where’s the ambulance?” I passed Lhanbryde, Mosstodloch and Fochabers and there was still no ambulance. Then it started to hit me, “What if they had to pull over? What if something has gone wrong in the back of the ambulance?” We were warned about that, and I had been raising that on behalf of constituents. The ambulance never came. I was going up the Dramlachs between Fochabers and Keith, and I suddenly saw the blue lights in my rear-view mirror, and I have never been happier in my life, because I knew at least she was still progressing through to Aberdeen.
To cut the story short, we got to Aberdeen. I could not find the maternity suite. It is a big hospital. Dr Gray’s is easy to navigate; Aberdeen is not. Our son was born safely and healthily, but that is a journey that no mother in labour should ever have to make, and no father or family member should have to follow the ambulance. My hon. Friend said that often fathers were kept in the dark. I have never felt more in the dark than during my 90-minute drive to Aberdeen on my own, worried about what would happen to my wife and child. This has been going on for far too long. A temporary downgrade for 12 months was bad enough; for it still to be happening in 2023 is shameful and unacceptable, and I will always stand up in this place and at Holyrood to call for Dr Gray’s to have a full consultant-led maternity unit.
The last case I want to articulate is that of another constituent who gave birth this year. I will read out her birth story, because it goes to the heart of birth trauma. There are elements around surgery and what my hon. Friend so bravely articulated that are unacceptable, but the birth trauma in this case is equally unacceptable and has had a long-term impact on my constituent. She wrote on the local Facebook page for the campaign group, Keep MUM, which does outstanding work. It is the group that got the maternity unit established at Dr Gray’s many decades ago. Marj Adams led that campaign, and she is now, with her daughters, leading the Keep MUM campaign to get it reinstated. It has an excellent Facebook page that shares these stories. The mum said:
“I was lucky enough to have my first baby at Dr Gray’s in 2020, two years after the unit was downgraded. Although the fear of transfer was high at all times, the actual experience of being able to labour at home for as long as possible and make my way into the hospital when I felt ready which is five minutes’ away from my house was amazing.
I had my second baby in 2023 and, due to last minute complications, I was told I had to give birth in Aberdeen. On the morning that my contractions started, I phoned Dr Gray’s and was advised to make my way through to Aberdeen asap as it was my second pregnancy and, because of this, they wouldn’t turn me away. We drove through, I was contracting the whole way there, which was horrible.
When I arrived at Aberdeen and was examined in triage, I was told I was only 2 cm so would need to go home as ‘women labour the best at home’. I explained that I was from Elgin and this wasn’t possible as it’s a 4-hour round trip and this is my second pregnancy and I progressed quickly with my first pregnancy.
They then advised that we would need to book a hotel as we couldn’t stay at the hospital as they don’t have space.”
So a mum in labour who had been told by Dr Gray’s to go to Aberdeen and that she would not be turned away, was being turned away. She continues:
“So we frantically tried to find a room to book and managed to get one just down the road from the hospital, but check-in for the room wasn’t until 3pm, and by this point it was only 12 pm. We asked if we could stay a few more hours at the hospital and we were told ‘no’.
I was then contracting heavily in the hotel car park, my waters had gone and were leaking everywhere and I was crying my eyes out feeling so scared and uncomfortable. I phoned the hospital back around 2 pm and explained that the contractions were a lot stronger and closer together and asked if I could come back in, but they said they didn’t have space for me so I could only come back in at 3pm. So I waited for another hour and, by the time I got to triage and was examined, I was 7-8 cm. My baby was born 30 minutes later.”
The mum finishes by saying:
“The whole experience was awful and felt inhumane. I had several panic attacks throughout and afterwards and I still feel panicked when I think about it now.”
She could not give birth close to home as she wished. She had to drive through a horrendous journey from Moray to Aberdeen. She was turned away by a hospital. Her waters broke in a hotel car park where she was seeking refuge before she went into labour, and her baby was born just 30 minutes after finally being admitted to the hospital.
The hospital and NHS Grampian have rightly apologised for the appalling way in which they treated my constituent, this mother. The trauma that she went through and the fact that it still affects her shows that today’s debate is important; in it, we can articulate in this place the concerns of our constituents. I have been proud to be part of the debate and to listen to outstanding contributions from colleagues. I hope that mums here in Westminster and watching from home feel reassured that their parliamentarians across the House will stand up for them to ensure that these birth traumas can be minimised and hopefully be completely ruled out in future. It should and must always be the happiest time of our lives to bring new people into this world. It is a shame that too many people continue to suffer from birth trauma. Let us do everything we can to reduce it.

Helen Morgan: I thank the hon. Members for Stafford (Theo Clarke) and for Canterbury (Rosie Duffield) for bringing forward the debate. The hon. Member for Stafford gave an excellent speech; it was brave but also extremely thorough. Given that a similar debate will follow shortly, I will restrict my comments to one specific area: my experience of having a baby. That was nearly 15 years ago, which is quite a long time ago, and I am pleased to report that my baby is now a healthy young man who is already significantly bigger than me. But my experience of his birth, and specifically the attitudes to the use of a caesarean section both generally in society and in the medical profession caused me concern.
I was induced at 12 days overdue at about 9 on a Friday morning, and my baby was delivered by emergency caesarean just before 10 on Saturday night, which I think we can all appreciate was quite a long time later. Various professionals looked after me during that time. They were invariably caring, humorous and competent. They had a good laugh at my birth plan and chucked it away and, when they had given up all hope of what they described as a “natural delivery”, I was wheeled across the corridor to a theatre and had the necessary procedure. That all went very well. I was very tired but happy and luckily my baby was making his views on the situation known at enormous volume. I was sent home after just a few days’ stay in hospital.
It was after I got home that things started to feel different for me. People kept expressing sympathy. The final straw was when a health visitor asked if I felt like a failure for having had a C-section. The answer really was, “Not until somebody suggested that maybe I should.” The medical evidence is clear that, if a vaginal delivery is possible, it is usually a superior option. I am not here to deny that, but I do think that we should take a look at attitudes to women who have had or needed a C-section because that was medically the best option for them.
I have a degree in history and chose to specialise where possible in medieval and early modern social and economic issues. I hope to God that my in-depth knowledge of the societal impact of the bubonic plague is never useful to me, but after my baby was born I found myself reflecting on historians’ best estimates of maternal and baby death in that era. It is possible that one in 10 pregnancies ended in the death of the mother, and the proportion of babies who died in those early days was obviously far higher. At the time, I found the reflection that, even 200 years ago, probably neither me nor my son would have survived extremely sobering and shocking.
Surely, given the amazing advances in modern medicine, we should celebrate that that is a statistic firmly consigned to history. Surely the only important objective when you arrive at hospital in excited anticipation of the arrival of your baby is that both you and your baby leave that hospital in a healthy state. I am afraid that the expectations of pregnant women are greater than that—that real women are expected not to rely on medical advances that have saved millions of lives over the last couple of hundred years but to have their baby without pain relief and without intervention, if possible without making too much noise—and definitely enjoying an empowering moment. Obviously that is total garbage: you are at your most vulnerable, both physically and emotionally, and then after what is potentially a traumatic and painful experience, you start the endurance test of caring for your new-born baby on zero hours’ sleep for probably the next four or five months.
Personally, having failed at being an earth mother, I found the first year of motherhood very difficult. I was sleep deprived and attempting to feed the world’s hungriest baby—this was not the fairy tale that I had imagined at all—but I was doing better than some of my friends. One friend had had what was described as a “natural” delivery. Her baby arrived six weeks before mine, but the consultant apparently did not like C-sections. Her baby was delivered in distress with forceps. She suffered terrible tearing and, in the end, despite my  having undergone major abdominal surgery, I was discharged before her. I am not an expert, but at the time it seemed to me that a C-section may have been a better outcome for her.
Another friend suffered a long and uneventful labour similar to mine. Again, the consultant did not like C-sections, so she ended up delivering her daughter with a last-minute smash-and-grab with a pair of forceps. Her baby was resuscitated on arrival and removed to the special care unit. My friend suffered flashbacks for years afterwards. Compared with that—I could not drive for four weeks, but overall I felt okay—I felt that my experience was superior. I was therefore particularly horrified when the Ockenden report was issued last year to see that a reluctance to perform C-sections was one of the factors in the failings of the Shrewsbury and Telford Hospital NHS Trust. In fact, it was generally considered on a nationwide basis to be a huge success not to use this lifesaving option wherever possible.
There are undoubtedly women who have experienced unnecessary trauma or worse because of a reluctance to use a C-section. I fear that what lies behind that reluctance is a failure to listen to women when they are having their babies and when they know what options would be best for them at that time. We celebrate advances in modern medicine and advances that save lives. I am not entirely sure why we do not fully celebrate the advance of a C-section. As I said, the objective when a woman is having her baby is to ensure that they both leave the hospital and arrive home in as good a state as possible. We must urge everyone in society and in the medical profession to ensure that that is their top priority.

Cherilyn Mackrory: First, I thank my hon. Friend the Member for Stafford (Theo Clarke) for securing the debate, and I thank her and the hon. Member for Canterbury (Rosie Duffield) for establishing the all-party parliamentary group on birth trauma. I co-chair the all-party parliamentary group on baby loss, and it is surprising, and remiss of us, that we have never focused on birth trauma as part of the work of that all-party parliamentary group. That could be why it did not feature heavily in the Government’s women’s health strategy. I am therefore thankful that my hon. Friend has brought the subject to Parliament front and centre and that we are talking about it.
I pay particular tribute to my hon. Friend for sharing her story. It was three years ago in my first Baby Loss Awareness Week debate that I stood in Westminster Hall and told my story, not realising how much it gets to you when you are speaking in a very quiet Chamber and in public. I was thankful to colleagues for intervening on me on that day so that I could just get through. So I understand exactly where she is today and think she has been incredibly brave. I hope that she continues to use the force she has inside her for good.
I also thank the hon. Member for Canterbury, who is clearly a powerful advocate for her constituents. It is appalling that her friends and family need to drop her name as they go to hospital for what should be a routine procedure—if we want to call labour a procedure. I am sorry that they have to do that, and I hope that the voices in this place will mean that that will not be case for much longer.
I thank my hon. Friend the Member for Moray (Douglas Ross) for highlighting what is a difficult time for dads. Listening to his speech made me think that, when we lost our baby, even though my husband was with me all the time, they did not ask for his opinion at all. Had he not been there, would they have done? I am not sure. I thank my co-chair of the all-party parliamentary group on baby loss, the hon. Member for North Shropshire (Helen Morgan), for her collaborative work on all things baby loss, and for sharing her story. She highlighted how dangerous labour and birth is. It has never been safe. We just did not evolve very well as a species in that regard. It is thanks to medical advances that we save as many babies and women as we do today in this country.

Rosie Duffield: Does the hon. Lady agree that the scandal of maternal deaths among black and ethnic minority women is especially horrific? We need to work with groups such as Five X More and highlight that in this place as often as we can, to end it as soon as we can.

Cherilyn Mackrory: I absolutely agree. We have done some work and a few inquiry sessions on that in the all-party parliamentary group. The disparity is outrageous. The Government are trying to put in place plans such as continuity of care, which I will come to. It is a particular passion of mine and I will speak about it a little later.
Since becoming the Member of Parliament for Truro and Falmouth, I have made it my mission to champion as many women’s health issues as I can, particularly baby loss. I have often talked in this place about what happened to me, though I will not go into my story today for fear of not being able to get through my speech. We have just had Baby Loss Awareness Week, which we will talk about in the next debate. Tackling often avoidable birth trauma is an integral part of that mission. Bringing life into this world is the most precious thing. Where women have unfortunate experiences, we must make sure that adequate measures are in place to support them and the mental health of their families. I thank all the women who have come today to support my hon. Friend the Member for Stafford and the work she has done for every one of them. It is a brave move to come forward and talk about your story, let alone collaborate, come to this place and advocate for other women who are watching at home. I thank them.
Every woman is different. The freer the flow of information between mothers and their doctors, the more tailor-made and informed the health provision can be. I am reassured that work has started in this space to start to empower women through informed maternity decisions. We have outlined that in documents such as the “Safer Maternity Care Progress Report 2021” and further progress reports over the last two years.
I have been particularly reassured and impressed by the engagement of our Minister through the various all-party parliamentary groups on women’s health. Let me take this opportunity to thank all colleagues who have been involved in boosting maternity issues. We are lucky to have a Minister who understands this area completely, having worked in the sector. She does all she can to keep us informed of developments, and when we do not get things right, she takes it on board.
Delivering a more informed maternity provision in our hospitals has the potential to reduce birth trauma caused by inappropriate methods of birth for a specific  mother with specific needs, which is even more important when considering that seven in 1,000 babies born to black mothers are stillborn. If we are able to provide evidence-based information to mothers from all backgrounds on what options best suit their needs, we will undoubtedly get to grips with the inequalities in pregnancy outcomes.
In my role as chair of the all-party groups I mentioned, I have heard so many stories from women about their experiences. Some are simply traumatic and some should never be allowed to happen again. When my hon. Friend the Member for Stafford told me she would come forward with her story and had the fire inside her to start a campaign, I gave her a word of warning from when it happened to me. You tell your story once, and you think you can pack it away until you need to think about it again. When you are constantly talking to other people who have been through a similar thing, you are constantly thinking about your own experience as well. Some days you can put on a front, put your armour on, get through it and be that shoulder for them to cry on. Other days it is not as easy. My advice to anyone who has been through it is to look after yourself first, please. You cannot look after others unless you have looked after yourself.
In so many of these stories, women talk about their excitement for what is to come, and the search for answers afterwards when things go horribly wrong. We have a duty to make sure that every time an expectant mother visits a hospital, midwife or local GP, they receive full and proper advice from someone who is fully informed about their case. That is why I come to continuity of carer. It has been proven to work. In areas of the country where we have high numbers of mothers living in social deprivation or ethnic minority mothers, it has already been put into practice by the Royal College of Midwives and various health trusts. We know that it works, but the problem at the moment is the lack of midwives to roll it out nationwide. The Minister is alive to this; she understands it. We are seeing more young people going into midwifery. We have a lot of first-year students at the moment. I am pretty confident that in the years to come we will start to see more midwives deployed on wards, and continuity of carer will start to become a reality.
Really, the message is simple to any healthcare professional: just listen to women. Listen to those who advocate for women when they are in labour. Just listen. If you can, listen rather than think you know what is going on. Taking a step back, listening to what is happening and having a conversation rather than rushing and panicking often leads to a better outcome.
My hospital, the Royal Cornwall Hospital in Treliske in Truro, has improved its maternity care a lot in the last 10 to 15 years. We are also getting a new women and children’s hospital as part of the new hospital programme. Thanks to those two factors, unlike other parts of the country we have no midwifery vacancies in Cornwall. Not only that, we have a waiting list of people wanting to be midwives. I pay tribute to Kim O’Keeffe, the chief nurse officer and deputy chief executive of the hospital, and all her team, for their relentless work in this space. They are working in a decaying building at the moment, but even so we are in a much better place than we have been. The women in Cornwall who are to give birth are in a much better place than they were 10 to 15 years ago.
I want to put on record just how desperate birth trauma is. Even a healthy birth—like my first birth—is a shock if you are not expecting it. It is something that happens to you; you have no idea what is happening.  Even afterwards, if it is all fine, you think, “My God, what just happened?” It is a shock that can still bring on post-natal depression, because of the relentlessness of looking after a brand-new baby. I have had two pregnancies and two births: one straightforward live birth, and the second a stillbirth. That was a straightforward birth physically, but mentally completely traumatic, because I knew I was giving birth to my baby who was not alive. I had to recover from that and grieve, and I knew what was wrong: my baby was not well enough to survive. The shock was over a whole weekend rather than a matter of hours.
We have heard stories today, and I will briefly tell the story of someone very close to me. She was seen as low risk, rushed into hospital and the baby was stuck in the birth canal. She was rushed in for an emergency section. Her husband was nowhere to be seen, because he was sidelined. There was a loss of blood. It took my friend six years before she would fall pregnant again. Luckily, she has a new baby—a little brother—who was born last month. She was frightened all the time about premature labour and whether it could happen again, and whether she should get pregnant again. After my stillbirth, I was too scared to get pregnant again, and I already had a daughter so I did not. It is different for every woman and family; there is not one fix for everyone.
I go back to my previous point that we just have to listen to women. All the services around maternity, during labour and afterwards, including counselling services, must be there because the woman—or the birth partner, the dad—has asked for them. Some women will sail through everything and be fine, but some will not. We need to ensure that, regardless of what they ask for, we are listening.

Rosie Winterton: I call the SNP spokesperson.

Kirsten Oswald: It is a real privilege to follow such a powerful speech by the hon. Member for Truro and Falmouth (Cherilyn Mackrory). I put on the record my gratitude to the hon. Member for Stafford (Theo Clarke), who opened the debate. She has my utter admiration for her bravery in coming here and sharing her experience. It must have been extremely difficult, but she got her important points across none the less. All the speeches today have been powerful.
It is important that we discuss the significant trauma that too many women experience. It can be caused by a whole range of things, as has come through powerfully. There is no one-size-fits-all formula, as the hon. Member for Truro and Falmouth pointed out, but that is all the more reason for us to take seriously the shocks and trauma that can follow birth.
Let me also record my great admiration for the tireless, immense and important work of my hon. Friend the Member for North Ayrshire and Arran (Patricia Gibson), who has just made an unscripted arrival in the Chamber, to support women affected by the terrible trauma of stillbirth and baby loss.
Research shows that 4% to 5% of women who give birth develop post-traumatic stress disorder. We have heard about the Birth Trauma Association’s vital work  to convey the difficulties for women and, indeed, fathers—partners. I was glad that the Royal College of Obstetricians and Gynaecologists provided a briefing for the debate, in which it talks in detail about some of the challenges that people face. Up to 9 in 10 first-time mothers who have a vaginal birth will experience some sort of tear. We have heard in detail about some of the significant injuries and traumas that can happen. We must not underestimate the impact of those and other traumas. The hon. Member for Stafford set out clearly the broad range of trauma with respect to both the physical and the mental wellbeing of mothers, as well as the long-term impact of lots of the traumas that women experience.
Like other speakers, I have been contacted by a number of women who wanted to share their story. I will concentrate on one particular story, which dates back to 2006. The woman who was in touch with me described her experience as “horrendous”. As far as she and her partner could see, things had been going along smoothly, everything was planned, and they were not made aware of any risk factors, but things started to go wrong. She experienced an unconsented “stetch and sweep” of the cervix—“while I’m in there anyway” was how it was put to them. She correctly asks how many patients in any other circumstance would feel that it was okay for a medical professional to perform an additional unconsented procedure just because they were in that area of the anatomy anyway.
Of course, such utter lack of care is not the norm—all the great NHS staff who work in this area have my admiration—but in the small number of situations in which it occurs it can have a big impact on women. The lady who was in touch with me said that the pain she experienced during the birth was
“visceral, white-hot soul destroying misery.”
She was unable to return to work because of the impact and she needed further time off for surgeries. She eventually received a diagnosis of PTSD. She pointed out that women are not listened to, a point that others have made and one that I will come back to, but she also pointed out the long-lasting impact of her experience. As well as looking forward to the children who were delivered going forward into adulthood, she and her partner are still looking back on that trauma, which continues to have an effect on their lives.
I have not experienced what that lady did. I am fortunate that the emergency caesarean section that I had was one of the calmest experiences of my life—that is my good luck, I think—but I remember how acutely vulnerable I felt giving birth and being in hospital. I do not know how I would have coped with the additional challenges that we have heard about today.
I am glad that we have heard about the particular challenges faced by black and Asian women. Statistically, they face significantly more challenges, including the greater number of women who die during pregnancy or shortly thereafter. Significant work is needed on that. We cannot just shake our heads at the statistics; we need to make sure that they lead to action.
It is probably timely also to mention the worry that I am sure we all feel for mums and expectant mums in places in the world where things are much more challenging. I have no doubt that we are thinking of the mums in Israel and Gaza who are dealing with the most challenging of situations.
The hon. Member for North Shropshire (Helen Morgan) spoke about how we are expected to grin and bear it in the situations that we have been discussing. That is absolutely unreasonable, but there is a narrative in some quarters that this is just what women have to put up with and they should just take it. I do not think that that is acceptable at all. As a number of Members said, we need to listen. The hon. Members for Moray (Douglas Ross) and for Truro and Falmouth made that point eloquently.
I spent yesterday at the Women and Equalities Committee talking about women’s experience of not being listened to in the context of their reproductive health. The impact of that on women’s lives can be profound and last many years. We are dealing with the very same situation here. Most of the time, women give birth in an uncomplicated and unchallenging way, and things go well. We are grateful for that. But often enough, things do not go the way that they should. One key way that we can make that better is by actively listening to women and taking their opinions into account, given that the care for them and their children will be impacted.

Rosie Winterton: I call the shadow Minister.

Abena Oppong-Asare: I thank the hon. Member for Stafford (Theo Clarke) for securing this important debate. I know that she has worked hard to raise this issue both in the Chamber and through her work outside it. I want to express my deep admiration of her for sharing in public such a moving story about a terrifying experience. That takes a lot of courage.
I thank my hon. Friend the Member for Canterbury (Rosie Duffield) for her kindness and congratulate her on her work on the newly launched all-party parliamentary group for birth trauma. I know that it will be successful and productive. I thank the hon. Member for Moray (Douglas Ross) for sharing his personal story and being an ally. He rightly said that it is shameful that this is happening in 2023, and that is linked to what my hon. Friend the Member for Canterbury said about how her friends and family have to name-drop her before they can get the support that they deserve. I thank the hon. Members for North Shropshire (Helen Morgan) and for Truro and Falmouth (Cherilyn Mackrory), too, for sharing their stories. I also thank the mothers with experience of this issue who are watching in the Chamber, and organisations that are working really hard on the issue.
This has been a very constructive debate. As we have heard, birth trauma is a difficult experience for anyone, but it has been in the shadows for far too long. It is right that we are speaking about it today and making it clear to the Government and all Members of the House that there is progress to be made. Pregnancy, birth and becoming a parent can be a special and rewarding time for many people. It is the start of an exciting journey into parenthood and a time to celebrate new life. However, it is clear that, at a moment of such importance and sensitivity, when complications occur the right support does not always follow. The statistics on maternity outcomes lay bare the problem that we face. The level of support is down, satisfaction is down, and confidence and trust in the system is down.
The Care Quality Commission’s “Maternity survey 2022” reported that women’s experiences of care had deteriorated in the last five years. The proportion of women contacting a midwifery team who were given the help that they needed during antenatal care dropped from 74% in 2017 to 69% in 2022. As for postnatal care, only 70% of mothers were “always” given the help that they needed when contacting a midwifery or health visiting team, a fall of nearly 10% since 2019. The downward trends continue: less than half—just 45%—said that they could “always” get support or advice about feeding their babies during evenings, nights or weekends, down from 56% in 2017, and just 59% said they were always given the information and explanations that they needed during their care in hospital, down from 66% in 2017.
What those statistics show is that mothers do not have full confidence in our system, and things are only getting worse. It is therefore not surprising to hear that, according to the Birth Trauma Association, between about 4% and 5% of women who give birth develop a post-traumatic stress disorder: that is about 30,000 women a year in the UK. The symptoms include flashbacks, nightmares, and extreme anxiety that make daily life immensely challenging. This is a shocking and sad indictment of the current system and shows how much more needs to be done.
We should also not forget the vast health inequalities that exist across Britain. We should all be aware of the fact that women in the nation’s most deprived areas are 3.5 times more likely to die from an avoidable cause than those in the least deprived areas, and the fact—mentioned by my hon. Friend the Member for Canterbury —that maternal mortality among black women is currently almost four times higher than it is among white women. That is why Labour’s mission sets an explicit target to end the black maternal mortality gap. The pandemic, of course, exacerbated those existing inequalities, particularly among the most vulnerable women in our society. As we heard from the hon. Member for Stafford and my hon. Friend the Member for Canterbury, the feelings of anxiety, helplessness, and fear that those with birth trauma endure are traumatic for all, but for women also to know that they are more at risk because of their race, their income or where they live is shocking, sad and wrong.
Yesterday, along with the shadow Secretary of State for Health and Social Care, my hon. Friend the Member for Ilford North (Wes Streeting), I met representatives of the Maternal Mental Health Alliance. They welcome the roll-out of maternal mental health services in some parts of the country, focusing on those with mental health difficulties arising from trauma or loss related to childbirth, fear of childbirth, miscarriage, stillbirth, neonatal death, pregnancy termination and loss of custody whose needs are not currently met by other services. What concerns them is that these services are not available in every part of England. As the hon. Member for Stafford pointed out, there is significant variation in the support offered by the services that been rolled out so far, creating a postcode lottery for women, babies and families. The alliance is also concerned about the lack of sustainable funding for many services. These are fundamental services providing vital care for women; they are not luxury extras. We need to ensure that in all parts of the country, women who have experienced birth trauma and are struggling with their mental health  have access to specialist support, and that there is continued funding in every area to meet the level of need that we know is out there. That is the alliance’s ask of the Minister.
I want to make it clear that I am not saying we do not appreciate the vast majority of our NHS and healthcare workers. Labour believes that the NHS is the backbone of our country, and will never abandon the founding principles of the NHS as a publicly funded public service, free at the point of use. However, as with so many other issues, this Government are presiding over a healthcare system that is going backwards rather than forward. It is the Government’s role to break down barriers and solve the difficult problems that we face, but it sometimes seems that those barriers are becoming higher and higher.
I want to raise with the Minister some concerns about the women’s health strategy. It lacks a plan to tackle the increasing waiting lists and a plan to enhance maternity care standards, and it fails to address the persistent staffing shortages. As my hon. Friend the Member for Enfield North (Feryal Clark) has said previously, it is plainly inadequate. The Royal College of Midwives told me this week that fundamental to delivering better maternity care is having enough midwives. The fact is that midwives are leaving the profession in droves, and the Government are failing to stop it happening. The Minister must tell us how she plans to keep the staff whom we currently have and ensure that the problems do not continue to worsen.
On top of those shortcomings, there is the problem that when a mother needs mental health support, the resources simply are not there. Midwives do not have the expertise or the time, and the result is that parents’ mental health is not being fully assessed. Overall, patients seeking mental health treatment spent more than 5.4 million hours waiting in A&E in 2021 and 2022. The reality is that patients are waiting or being overlooked rather than getting the support that they need. It is therefore no surprise that the deputy chief executive of NHS Providers has said that mental health services are over- stretched and understaffed, and that trusts are deeply concerned about the levels of unmet need. We need measures to address all these problems early.
Let me end by again congratulating the hon. Member for Stafford on securing the debate. I know it is not easy for her to share her story, and I hope she feels reassured that she has taken a significant step today in raising such an important issue.

Maria Caulfield: I, too, congratulate my hon. Friend the Member for Stafford (Theo Clarke) on her courageous speech, in which she described the birth of her daughter and the terrifying experience that she had. It is good to hear that she received such great support from her NHS team, but concerning to hear of her negative experiences—and as a former Minister for maternity services, I know that they were not isolated and that many others will have had similar experiences. My hon. Friend is a tireless advocate for women who have suffered birth trauma, and I pay tribute to her for the work that she has done and, I am sure, will continue to do.
I also congratulate Members on both sides of the House who have shared their personal experiences and those of their constituents, including my hon. Friend the Member for Truro and Falmouth (Cherilyn Mackrory), who does so much in the area of baby loss, and who I am sure will speak in the next debate. The hon. Member for North Shropshire (Helen Morgan) talked about her experience of a caesarean section, and I want to reassure her that we are trying to move away from terms such as “normal” and “natural” to the term “a safe birth”, whether that refers to a “natural” birth or a C-section. I have been working with the hon. Member for Canterbury (Rosie Duffield) on the East Kent inquiry and its recommendations, and have met many of her constituents who also shared their traumatic experiences about the care they had received.
I thank my hon. Friend the Member for Moray (Douglas Ross) for sharing his experience as a partner, and also for pointing out that many of these issues apply to all four nations of the United Kingdom. I respond as the Minister for services in England but, obviously, I work closely with devolved colleagues to try to ensure a consistent service across the country.
I have listened very carefully to the contributions and pay tribute to everyone for their courage in sharing their stories. Before this debate, I was pleased to meet my hon. Friend the Member for Stafford to talk about the issues she has raised and to share with her the many pieces of work that the Government are already starting, after they were shared by women across the call for evidence on the women’s health strategy and by meeting many women across the country to discuss maternity services. We clearly need to do much more in this space, but I will also share some of the progress we are making.
I salute the work of the newly established all-party parliamentary group on birth trauma, chaired by my hon. Friend, which is showcasing an issue that very few people like to talk about. She discussed breaking the taboo, because even women who have been through birth trauma are often very reluctant to talk about this difficult subject, but the issue affects thousands of women. We can see from the response in the Gallery how important it is that we break the taboo and talk about these issues, both to prevent birth trauma and to manage the consequences when it happens.
I commend the work of charities such as the Birth Trauma Association and the many campaigners who are here today. It is important that we highlight this issue, because many women going through pregnancy do not realise some of the choices that are available to try to prevent birth trauma in the first place.
Birth trauma and injury take a toll on women, both physically and mentally, and greater awareness from the public and healthcare professionals is crucial to preventing birth trauma and mitigating its impact on women’s lives. We have heard a number of examples of compassionate care, which is essential both in reducing and preventing injury and in helping women and their families to cope with the impact of injury when it happens.

Hannah Bardell: I am sorry that I was not able to be here for the speeches, but will the Minister join me in commending health practitioners such as Stephanie Milne, who runs Physio Village in my Livingston constituency? She does mummy MOTs, and  she talks a lot about birth trauma and how her work supports women who have been through birth trauma. Does the Minister agree that the NHS can do more to help women through such post-natal healthcare support?

Maria Caulfield: I absolutely pay tribute to them. We have heard some great examples of work happening around the country, but the point has also been made that it is not consistently available to everyone. Those examples show why compassionate care is a key part of the work we are taking forward, particularly in relation to Bill Kirkup’s report on maternity and neonatal services in east Kent, which was published last year. Dr Kirkup rightly emphasised the need for compassionate care and a change in culture as well as a change in practice for women throughout their pregnancy, labour and post-natal period.
Compassion, kindness and understanding all require women and their families to be treated as individuals and to be heard. That is something we heard strongly in our call for evidence on the women’s health strategy, to which we had over 100,000 responses. That is why birth trauma is mentioned in the strategy, and I will talk about that further.
As part of this, we have to recognise that the PTSD, psychological trauma or depression that a mother may experience also have to be supported. Just delivering a safe birth is not enough. Wearing my other hat as the mental health Minister, it is why new mums are a high-risk group in the suicide prevention strategy. It is a shocking statistic that the leading cause of death in new mums is suicide, but it is a very vulnerable time in a woman’s life. They are often isolated from work colleagues if they are on maternity leave and, if they are a first-time mum, they will not have a support network of other mums. We hear all over the place on social media what a wonderful time it should be in a mother’s life, that they should be blooming with a new child, but the reality can be very different. We have heard that today, whether it is issues around breastfeeding, not sleeping or just feeling isolated. On top of that, birth trauma can cause difficulties in not being able to drive and with being in pain—there is a whole raft of issues.
Through the work we are doing on maternity and focusing on new mums as a high-risk priority group in mental health, we are trying to drive forward changes to support women better.
I am pleased to have the opportunity to update the House on the wider progress we are making to improve outcomes in pregnancy. I fully understand the importance of preventing perineal trauma during childbirth. We have to be honest that we cannot always prevent it. I am not a midwife, but there are risk factors such as a larger baby, a smaller cervix or a long birth that mean trauma and injury will sometimes happen. There is no doubt that we need to do more to reduce the incidence of perineal trauma but, if it happens, we need to manage it in a much better way.
That is why I am pleased that NHS England has this week published a national service specification for perinatal pelvic health services, which it aims to roll out across England by March 2024 in order to end the postcode lottery of services. The specification states that the services will work with maternity units across England to implement the obstetric anal sphincter injury care bundle developed by the Royal College of Obstetricians and Gynaecologists and the Royal College of Midwives.
As my hon. Friend the Member for Stafford said, getting the specification rolled out across the country is an early success for the APPG. I am confident that this new guidance, which will be implemented across maternity units, will reduce the rate of anal sphincter injuries resulting from labour and vaginal births and help to manage such injuries in a much better way when they happen.
The introduction of these services will broaden the core service offer of pelvic health beyond the existing NICE and RCOG guidelines on care for obstetric anal sphincter injuries. The services will make sure that all pregnant women get the advice and support they need to prevent and identify pelvic health problems, and that those who do have problems are offered conservative treatment options before surgery is considered, in line with NICE guidelines.
We all know the crucial role that midwives play in recognising women who are suffering perinatal mental illness, including by taking a trauma-informed approach to care. To support this, NHS England is refreshing its core competency framework for perinatal mental health. The shadow Minister touched on this, and I reassure her that, by the early part of next year, every integrated care system in England—I cannot comment on what is happening in Labour-run Wales—will have a fully working maternal mental health service to support mothers experiencing moderate, severe or complex mental health difficulties.
It is true that the number of women accessing perinatal mental health services has risen by almost 50% over two years, but that is good news because we want women to come forward. The challenge for the Government in England is being able to meet that demand. For too long, women have suffered in silence and isolation. When they come forward, we need to have the services to support them. This demonstrates that mental health services are more important than ever before.
A number of colleagues have identified the issue of inequalities in maternity care, and we know that some women, particularly Asian, black and working-class women, are experiencing poorer mental health and poorer outcomes in maternity across the board. That is why we continue to fight to introduce NHS equity and equality action plans across the country. I am proud of the progress we are making on developing resources, and I pay particular tribute to the maternity disparities taskforce, which is working with organisations to deliver this as quickly as possible.
A number of issues were raised in the debate and, touching on birth trauma in the women’s health strategy, we will fairly soon be updating our year 2 strategy and setting out our priorities. I will let Members know about that as soon as possible.
There is a lot we could talk about in this space, and I pay tribute once again to my hon. Friend the Member for Stafford and all colleagues who have shared their experience. I reiterate that this is a priority for the Government. We are seeing change, but more change needs to happen.

Theo Clarke: First, let me thank the Minister for listening to the calls of mothers across the UK and for taking action. It is fantastic news that NHS England will now be implementing the OASI care bundle to  ensure that we reduce birth injuries across England. I also thank her for working so constructively with me ahead of this debate. I am delighted to hear that there will be a refreshed update of the women’s health strategy, which I very much hope will include birth trauma.
Secondly, let me thank all the hon. Members who have spoken in the debate. In particular, I thank my hon. Friend the Member for Truro and Falmouth (Cherilyn Mackrory), who has done amazing work on baby loss and chairs the all-party parliamentary group on baby loss. I thank my fantastic APPG co-chair, the hon. Member for Canterbury (Rosie Duffield), for sharing the personal experiences of her constituents. I was also struck by the contribution from my hon. Friend the Member for Moray (Douglas Ross), who talked about the experience of dads, which we do not talk about enough in these debates; by the interventions from the hon. Members for North Shropshire (Helen Morgan) and for Strangford (Jim Shannon), my hon. Friend the Member for Wolverhampton North East (Jane Stevenson) and my right hon. Friend the Member for South Northamptonshire (Dame Andrea Leadsom); and by the contributions from many others. It has been a critical moment in history for us to hold today’s debate, and I hope that the women watching, both live on television and here today, feel that they have been listened to and heard. We have heard from the Minister that action has been taken today on birth trauma.
Question put and agreed to.
Resolved,
That this House notes that many women across the UK experience birth trauma; and calls on the Government to take steps to support women experiencing birth trauma.

Baby Loss Awareness Week

Helen Morgan: I beg to move,
That this House has considered Baby Loss Awareness Week.
I thank the Backbench Business Committee and all those who have supported this important debate. In particular, I thank the hon. Member for Sheffield, Hallam (Olivia Blake), who, unfortunately and unexpectedly, has been unable to attend. She sends her apologies to Mr Speaker for that. I also wish to thank the hon. Member for Truro and Falmouth (Cherilyn Mackrory), my co-chair of the all-party parliamentary group on baby loss. She is a font of inspiration, guidance and support, and I thank her for that. I joined the APPG shortly after being elected and became its co-chair earlier this year. I joined because many of my constituents had suffered the loss of a baby at Shrewsbury and Telford Hospital NHS Trust, and the Ockenden report on systemic failings there revealed that many women—indeed, whole families in Shropshire and the surrounding area—had suffered a devastating loss that was avoidable.
Baby Loss Awareness Week—which took place last week, while we were still in recess, but which we are marking with this debate—is an important moment to support any family who has lost their baby and to ask ourselves whether anything more can be done to prevent other families suffering this heartbreak. This time last year we debated the findings of the Ockenden report—most importantly, the need for safe staffing levels in maternity units across the country. One year on, I ask the Minister to update us specifically on the progress made and on the outlook for maternity services and safe levels of staffing in the future. Unfortunately, since the debate last year we have been starkly reminded that poor maternity care was not restricted to Shropshire. Dr Bill Kirkup has reported on his findings at East Kent and Donna Ockenden is currently reviewing issues at Nottingham, which threaten to be on an even greater scale than those at Shrewsbury and Telford.
Each time a scandal emerges, we promise ourselves that it will be the last time, but tragically that has not been the case so far. Far from being a localised issue, it seems that maternity services have been experiencing a crisis nationally. In 2022, 38% of maternity services were rated by the Care Quality Commission as inadequate or requiring improvement. The avoidable death of a baby is something we should be working to eliminate.
Earlier this year, I attended the launch of the joint report by Sands and Tommy’s joint policy unit on progress on saving babies’ lives. The headline of that report is that the Government are not on track to meet their target of halving stillbirths, maternal deaths, neonatal deaths and serious brain injury from their 2010 levels by 2025, and there is no target for further improvement beyond 2025. The report also showed that in 2021 there were 13 babies per day who were stillborn or died within the first 28 days of life across the UK. In 2021-22, nearly a fifth of stillbirths were found to have been potentially avoidable if better care had been provided, and two thirds of action plans created following the death of a baby are rated as weak. Too often, avoidable losses continue to occur as a result of care that is not in line with National Institute for Health and Care Excellence  guidance. For example, data for England show that 40% of women and birthing people do not attend their antenatal assessment before 10 weeks’ gestation, as is recommended in the NICE guidelines.
Research must be the key to improving outcomes and saving more babies’ lives in the future, yet relatively little is invested in pregnancy-related research. For every £1 spent on maternity care in the NHS, only 1p is spent on pregnancy research. Worse, health inequalities are stark when we look at baby loss. Black babies are twice as likely to die in their first 28 days as white babies, and black ethnicity is associated with a 43% higher rate of miscarriage than white ethnicity. In England and Wales, in 2021 the stillbirth rate for women from the black African ethnic group was seven per 1,000 births, which would have to reduce by more than 60% in four years to meet the 2025 overall population target of 2.6 per 1,000 births. Stillbirths are almost double the level among people living in deprived areas in the UK than they are among those in the least deprived areas.
There is also a real lack of evidence in this area. Much of the national data is based on aggregated ethnic groups or broad categories of deprivation, which provide limited insights into individual lives. Despite the Government’s commitment to levelling up, there are no national targets and no long-term funding for reducing inequalities between ethnic groups or areas of deprivation. I know that the Minister has read that report and engaged seriously with these issues, and I urge her to consider its recommendations in full.
My constituents Kayleigh and Colin Griffiths, along with Rhiannon Davies and Richard Stanton from Telford, campaigned tirelessly for the Shrewsbury and Telford Hospital NHS Trust review, and I was pleased that they were each awarded an MBE earlier this year in recognition of their efforts to ensure that parents’ voices were heard and that babies born in future would be safer. They have reflected on the new concerns that have come to light and have written to the Secretary of State to request a public inquiry into maternity services in England, given the apparently alarming scale of the national problem. Unfortunately, they have not yet received a response to that letter. Will the Minister confirm whether the Secretary of State will be replying to that letter, and whether the Government will consider nationwide action to fully understand why maternity services have come under so much pressure and how to prevent avoidable baby deaths in future?
We should always remember that these are not statistics but the horrific experiences of women at their most vulnerable. A constituent wrote to me this week following her own experience at Shrewsbury and Telford, one about which Donna Ockenden’s team concluded that different management would reasonably have been expected to have made a difference to the outcome. My constituent said:
“My son was born 10 days overdue on 7th August 2007 in Shrewsbury hospital. Unfortunately, due to gross negligence by the trust that day I left their hospital with empty arms and a broken heart.”
Shrewsbury and Telford Hospital NHS Trust accepted all the findings of the Ockenden report and regularly reports its progress against the recommendations. I am in regular contact with the trust’s team, and they reported that 75% of the recommendations in the report had been delivered and assured, and that there is good  progress on the remainder. Of the recommendations in the earlier first report, 88% have been implemented and assured, and I have also received assurances that staffing levels in the maternity service are at an acceptable level. However, Donna Ockenden also recommended immediate and essential actions for the whole of the UK in both her first and second reports. I hope the Minister will be able to provide us with an update on progress on those actions, particularly on safe staffing, training and culture within the maternity service.
I also want to consider those awful circumstances where the loss of a baby is unavoidable and the cause often unknown. In 2021, the cause of 33% of stillbirths and 7% of neonatal deaths was unclear. The all-party group on baby loss has heard devastating evidence from parents who have been left in limbo for months or even years waiting to find out why their baby died, because of a desperate shortage of perinatal pathologists. A survey conducted by Sands in 2022 found that delays in parents receiving post-mortem results have significantly worsened over time. More than a fifth of parents reported waiting up to six months or more for the result of their baby’s post-mortem.
In October 2022, an interim policy for the commissioning of perinatal post-mortems was adopted, which defines inclusion and exclusion criteria as to which cases will be offered a perinatal post-mortem. Since this policy was adopted, no audit of the impact has been undertaken, with NHS England acknowledging that communication of the interim policy has fallen short. Sands has received anecdotal evidence of consent takers being unaware of the new approach and it is concerned that that has led to parents not being fully informed about consent.
There are currently just under 50 full-time equivalent paediatric and perinatal pathology consultants in post in the UK, with an additional 15 vacant consultant posts. The number of current trainees is insufficient to fill these vacancies according to the Royal College of Pathologists. Will the Minister provide a clear commitment and timeline for the recruitment of perinatal pathologists, to ensure that no bereaved parent ever has to wait more than six months for post-mortem results?
It is obvious that staffing remains the single most important issue for maternity services. In a survey commissioned by the Sands and Tommy’s joint policy unit, 84% of midwives who were asked disagreed that there were enough staff around them for them to do their jobs properly. A decrease in staffing levels has been down to staff sickness rates over time and job satisfaction. In 2022, 63% of midwives in England had felt unwell in the past 12 months because of stress.
NHS England has recently published its long-term workforce plan and the Government have provided an initial financial commitment of £2.4 billion over the next five years to fund education and training. Will the Minister consider the importance of long-term recurrent funding, as well as investment in retention? Without that, there is a risk of losing valuable experience and skills in the existing workforce. The workforce plan models the number of future midwives required, but does not include other staff groups, which risks ignoring some of the areas and specialisms in the wider maternity and neonatal workforce, where staffing issues are most acute.
We all know there is no magic money tree, but it is a false economy to continue to deliver services that are potentially unsafe. According to Sands, the cost of  harm from clinical negligence caused by NHS maternity services was £8.2 billion in 2021/22—60% of the total cost of harm from clinical negligence in the NHS and more than double what the health service spends on maternity care in the first place. The cost of failure is always so much higher than the cost of success.
In conclusion, while the Government’s commitment to the recommendations of the Ockenden report was welcome, there is a still a long way to go to deliver world- class maternity services and meet the Government’s own target of halving baby loss by 2025. Too often, harm continues to occur as a result of care that is not in line with nationally agreed standards. Listening to the voices and experience of families must be at the heart of policy, but most importantly we must ensure staffing levels are safe, so that no one leaves hospital with empty arms and a broken heart, where that might have been avoided.

Tim Loughton: It is a pleasure to speak on this important subject. I pay tribute to the hon. Members for Sheffield, Hallam (Olivia Blake) and for North Shropshire (Helen Morgan), and the others who have secured the debate. It has become something of a tradition that we mark Baby Loss Awareness Week, although we were not able to do so last week because of the recess.
This has also become one of the more emotional and harrowing debates—I have sat through many debates over many years—which is a great tribute to how this place has progressed. When I first came to this House all those years ago, as you did, Madam Deputy Speaker, baby loss was a subject that was not discussed. Certainly, the personal experiences of Members, particularly female Members, going through the trauma we heard about in the earlier debate and through baby loss generally, let alone the experience of partners, did not come out into the open. The stigma surrounding mental health meant that no Member of Parliament would dare to raise in public the fact that they might have some mental illness problems. Why would they not? A lot of the population have such problems, and we are just humans like the rest of the population, doing a particularly stressful job.
The progress that we have made over the 26 and a half years that we have been in Parliament, Madam Deputy Speaker, is a real tribute to this place, and to the bravery and openness of hon. Members who have come forward with their personal experiences. Those experiences enrich the way in which we scrutinise Government Departments, rules, regulations and legislation that needs to be brought in to deal with related problems. I pay tribute to all those who have shared their experiences. I was listening to the previous debate in my room, in between meetings, and I particularly pay tribute to my hon. Friend the Member for Stafford (Theo Clarke), as she said it was the first time that the specific issue of birth trauma had been mentioned here. She opened up incredibly emotionally about her own experiences.
I am glad that in my hon. Friend’s winding-up speech she mentioned how the issue affects dads as well. It is not a female-only issue; it is a parents issue. Where there are two parents involved in a child’s life, the impact of baby loss can be incredible on the male parent, and we should never forget that. Too often, health officials  speak over the heads of fathers to the mothers, but fathers have an equally vested interest in what happens, not only to their partner but to their new-born baby as well.

Cherilyn Mackrory: Does my hon. Friend agree that the fact that aftercare for fathers is often lacking places a huge burden on relationships? Sadly, the statistics show that 50% of relationships can break down after the loss of a baby. Does he agree that we need to do much more to support fathers, as well as mothers, after the loss of a baby?

Tim Loughton: My hon. Friend, who again has great experience and has been exceedingly forward with her own experiences, is absolutely right. There have been many studies on maternal perinatal mental health problems. The latest estimate is that that costs this country over £8 billion, and there has been an increase in perinatal mental health problems among women, exacerbated by the lockdown.
As happened to our own colleagues, for many months babies born during lockdown did not come into contact with another baby, or with extended family members such as grandparents, who would usually be at the hospital bedside to welcome a new baby, but were not allowed to be there. Speaking as the chairman of the all-party parliamentary group for conception to age two: first 1001 days, we are only starting to see the considerable impact of that on babies. We will only start to see that as those babies grow up and go to school.
However, there have not been as many studies about the impact on the mental health of fathers. There is good evidence to suggest that fathers can suffer considerably, yet the support networks, which are still not good enough for mums, are not nearly good enough for fathers. It is a false economy not to support that.
In a minute, I want to have another rant about my Act, the Civil Partnerships, Marriages and Deaths (Registration etc) Act 2019—that is the real reason for my coming to this debate, although I always try to take part, because the Act deals with stillbirth, in particular—but first I will make some general comments.
It is good that we are discussing this issue and that the profile is so much higher than it has been in previous years, but there is a lot of work still to do. The stillbirth rates have come down and there has been progress. Back in 1993, there were 5.7 stillbirths per 1,000 births. There were 2,866 stillbirths in 2021, so the figure is now about 3.8 or 3.9 stillbirths per 1,000 births. There has been progress, but in order to get to the target under the national maternity safety ambitions, which was launched in 2015, we need to get that figure down to about 2.6 by 2025, so there is a lot of work still to do on stillbirths.
Compared with other European countries, our record on stillbirth remains poor. We rate sixth worst out the 28 European Union countries plus the UK. The countries below us are Bulgaria, Malta, Croatia, Slovakia and Romania, which have perhaps traditionally not had as advanced and sophisticated health services as we have in this country. There is no real excuse why we have not made more progress.

Patricia Gibson: The hon. Gentleman is correct in what he is saying. Does he agree that one of the problems across the UK is  that, on the whole, most of the stillbirths we have are preventable? When mistakes occur, as they inevitably will at times, there is a culture of cover-up and secrecy, so the lessons that need to be learned are not being learned, because NHS trusts and health boards are too busy trying to cover their backs rather than finding out what went wrong.

Tim Loughton: The hon. Lady gallops way ahead of me; I will come on to speak about that. That is what my private Member’s Bill, now an Act, seeks to address, so I will come back to those comments.
Stillbirths are not the only issue. Progress has been poor on neonatal death rates, which have plateaued for some years and are even further away from coming down to those 2025 targets. There were 1,719 neonatal deaths last year—that is deaths within 28 days of being born. There is also the whole subject of miscarriage. I will not go into great detail on that, but we know that at least one in five pregnancies end in miscarriage, and there are probably more that we do not know about. The Government have done a lot of good work on this. I pay tribute to the former Health and Social Care Secretary, now Chancellor of the Exchequer, for his emphasis on safety in hospitals, particularly safety around maternity, and for the launch of the Safer Care Maternity action plan back in 2016, which were all about improvements in maternity safety training. The Our Chance campaign was targeted at pregnant women and their families to raise awareness of symptoms that can lead to stillbirth.
The inauguration of bereavement suites in hospitals was another important development—I have seen my own in Worthing. It was wholly unsatisfactory that a woman, following a stillbirth, would be placed in a bed next to a mother who had fortunately had a healthy, screaming baby. The impact on the mother and the father of having a stillbirth and then seeing the reverse was traumatic and had to be dealt with. The bereavement suites provided a more discreet, private area, away from those mums lucky enough to have healthy babies.

Douglas Ross: I am grateful to my hon. Friend for giving way. It allows me the opportunity to welcome the fact that, last week, NHS Grampian announced the upgrading of the bereavement suite at Dr Gray’s Hospital. Marsha Dean from Elgin, one of two bereavement specialist midwives in the NHS Grampian area, welcomed that. Tina Megevand from Moray Sands said, “It’s so very important that anyone affected by pregnancy loss or death of a baby gets the best possible bereavement care and is offered a safe, protected space to spend time and make memories with their baby.” What my hon. Friend has just said is crucial and I just wanted to put on record our appreciation in Moray for having such a facility.

Tim Loughton: I am grateful to my hon. Friend for putting on record what his local hospital is doing, and I hope that that is happening around the country. Certainly, my own hospital takes great pride in its bereavement suites and they have made a big difference to the impact on parents in its maternity wing.
We have had the Ockenden report as well as the Cumberlege review, so there has been a lot of activity from the Department of Health and Social Care, but we  need to go so much further. Although I will not go into detail here, I wish to reference the high incidence of stillbirths and baby loss among the black, Asian and minority ethnic community, who are something like five times less likely to receive maternal aftercare.
As hon. Members have mentioned, there are also real challenges and big vacancies in the midwifery workforce. As has been said, 38% of maternity services have been rated as requiring improvements in safety, so there is still a long way to go. One thing that has particularly alarmed me—I am sure other hon. Members will have had the briefing from that excellent charity, Sands—is the state of perinatal pathology. I think my hon. Friend the Member for Truro and Falmouth (Cherilyn Mackrory) may be talking further on that. Currently, there is a significant proportion of parents who have to wait more than three to six months for their babies’ post mortem to be undertaken and for the results to be communicated to them. Those waiting times are then further exacerbated by poor communications about what is happening. Having gone through the trauma of losing a newborn baby, parents then have to wait a long time to find out what happened, which causes them additional trauma.
As I mentioned earlier, there is the whole issue of mental illness and, in particular, the impact of mental illness and depression and the prevalence among teenage mothers. It is important that we deal with that early and that the support is there because we know—the Minister mentioned this in the previous debate—about the high incidence of suicide linked to the perinatal period.
Therefore, this is an important subject. Good work has been done. The Government have good plans, but there is still a lot of work to do before we can genuinely say that this is a very safe country in which to give birth and we rank with the top countries across the rest of Europe.
I wish to talk about my excellent private Member’s Act, which passed through Parliament some time ago. Madam Deputy Speaker, you will not be surprised to hear me mention it again because I have raised it on the Floor of the House many times. I have harangued the Minister about it many times and will continue to do so.
My Civil Partnerships, Marriages and Deaths (Registration etc.) Act 2019 passed through its final stages in this House on 15 March 2019. It received Royal Assent on 26 March 2019; that is 1,303 days ago. It did four things. First, it enabled opposite sex couples to have a civil partnership. That became law on new year’s eve 2019. On that day, 167 couples availed themselves of that opportunity and many thousands have since, so we can tick that box. A second part of the Act enabled for the first time the names of mothers to be included on marriage certificates. Up until then, they did not exist, which particularly added insult to injury if it was the mother who brought up the child who was getting married and the father, whose name does appear, had never been on the scene at all. That at last was reversed with my Act—another tick.
Another part of the Act mandated the Secretary of State for Health and Social Care to produce a pregnancy loss review. A committee was set up—I sat on that committee —and in July this year the independent pregnancy loss review, which contained many recommendations—there were some good things in it, even though it had not met since 2018—was at last published, so another tick.
The fourth part of my Act was on coroners’ investigations into stillbirths. What was agreed by this House unanimously, with Government support, following much scrutiny in the other place as well, was that the Secretary of State must
“make arrangements for the preparation of a report on whether, and if so how, the law ought to be changed to enable or require coroners to investigate still-births”,
and that, after the report had been published, the Lord Chancellor may, by regulations, amend part 1 of the Coroners and Justice Act 2009. It was a very simple amendment to ensure that, in future, coroners had the power to investigate stillbirths. It did not require any more primary legislation. It required a one-line amendment to the Coroners and Justice Act.
When I made my speech for my private Member’s Bill on 15 March 2019, I could not have been more wrong. I said then that I knew that we were pushing at an open door with my last measure, as the Health Secretary had signalled his support for it at the Dispatch Box during a statement on stillbirths in November. I then set out the anomaly in the law where coroners in England have the power to investigate any unexplained death of any humans unless they are stillbirths. That is because a baby who dies during delivery is not legally considered to have lived. If the baby has not lived, it has not died and coroners can investigate deaths only where there is a body of a deceased person.
Most people agreed—certainly the coroners themselves, who strongly supported this—that that is an anomaly in the law. Given some of the scandals that I will come to in a minute, it has given rise to a suspicion—this is the point that the hon. Member for North Ayrshire and Arran (Patricia Gibson) raised—that some stillbirths that went unexplained might have been avoidable, and were mistakenly registered as stillbirths because that effectively excluded the coroner from launching a further investigation. My Bill was therefore simple in its aim.
A consultation was launched, actually before my Bill became an Act, because the Secretary of State was so supportive of it and saw it as a formality. The consultation on the changes closed on 18 June 2019—over four years ago—and has still not been published. In order for new regulations to come in, the consultation and subsequent proposals have to be published, but we still have not got over the first bar of publishing the consultation. I have frequently queried when the Government will publish the consultation, and have frequently received a barrage of excuses. Of course, covid was the first excuse for why the consultation results—not even the proposals—could not be published.
The matter was chased up by the Justice Committee, which produced its own report on coroners and reinforced the need to get on with the measures in my Act. That message was reinforced by the Health and Social Care Committee, which also produced a report to say that the Government needed to get on with the measures. Today’s Minister, for whom I have a lot of time, as my near neighbour in Lewes, has written to me several times. One of the excuses was that we needed to wait for the Health and Care Act 2022 to go through in the last Session because of various considerations that could have an impact. That Act passed last year, so is not a consideration anymore.
We then had to get the pregnancy loss review published, for which we had waited since 2019. That has now been published, as I have said. We then had the further excuse that the Ministry of Justice was dragging its feet. The problem is that it is a Department of Health and a Ministry of Justice issue. I have tackled the Minister for Justice on several occasions. I asked for a joint meeting with the Minister for Health and the Minister for Justice. That meeting was cancelled six times, until it eventually happened on 21 March this year, when I was told that everything was in hand and being sorted out. I raised the matter again in Justice questions on 12 September. I was told:
“Both the Health Minister and I are pushing this as fast as we possibly can.”—[Official Report, 12 September 2023; Vol. 737, c. 766.]
This is appalling. Madam Deputy Speaker, you and I have been in this House for an equally long time. I cannot remember a piece of legislation waiting to be enacted for as long as this, particularly when there appear to be no objections to it. It has been passed unanimously and is not contentious; the coroners want to do it. It is absolutely extraordinary. I will take this opportunity to put it out in the open yet again that the Government need to get on with this. The legislation is even more important now than when it was passed in 2019, and when I produced it as a private Member’s Bill in 2017.
Four things needed to be resolved about how coroners would look at these matters, and they have all been resolved. First, we all agreed that they should look only at full-term stillbirths. That is where a stillbirth is least likely to happen, and therefore more questions arise. I think that everybody agreed on that. Secondly, it should be at the discretion of the coroner. The coroner will certainly not want to look at every single stillbirth, but where questions are raised by the parent or others that something has gone a bit awry and we need more information, the coroner can decide at his or her discretion whether there is a case for further investigation. We are talking about dozens, or scores, of cases, not hundreds or thousands.
Thirdly, it will be up to the coroner to decide, even if the parents do not want a review. That was a difficult one, but there is evidence that some stillbirths can be brought on by domestic violence during pregnancy, and obviously there may be a cover-up because a mum is being coerced. It is right that there should not be a veto and it should be down to the coroner to decide. Fourthly, the coroners have decided that it is not a significant resource issue. We do not need to train up a fleet of specialist coroners; they always want more money, but they think that they can simply take on the responsibility. All those things have been resolved. There are no outstanding questions, but as I said the need for the legislation has grown since it went through.
I do not need to remind everybody about the various scandals that have happened. The Nottingham maternity review currently under way covers the latest of those revelations. It will be the UK’s largest maternity review, with 1,266 families having already contacted the review team with their concerns. The Shrewsbury and Telford Hospital NHS Trust review, which has already been mentioned, of the deaths of more than 200 babies and nine mothers between 2000 and 2019, found that 201 babies could or would have survived had the trust provided better care, and that families were wrongly blamed  when their babies died, were locked out of inquiries into what happened, and were treated without compassion and kindness.
The Morecambe Bay review in 2015 found unnecessary deaths of 11 babies and one mother between 2004 and 2013 due to oxygen shortages, mismanaged labour, failure to recognise complications, and so on. When the East Kent review was published, the headline was that the East Kent Hospitals University NHS Foundation Trust was logging baby deaths as stillbirths when in fact they were not stillbirths. What would the reason for that be? Potentially a cover-up, so that a further investigation by a coroner could not take place.
The East Kent review into the ongoing problems  with the trust was described as harrowing, with more than 80 concerns about midwives and nurses working at the trust investigated by the regulators since 2015, including cases involving the police. Eleven midwives and nurses from the trust have been struck off, suspended or placed under conditions in relation to such cases, and 64 doctors from the hospital have been subject to investigation by the General Medical Council over the last decade, with three struck off and three suspended. The report showed a failure to implement the recommendations of earlier reports, allowing failings to continue at East Kent, and at other hospitals elsewhere in the country.
It needs reinforcing that most nurses, midwives and doctors do a fantastic job in difficult circumstances. They most of all will want to ensure that incompetence by a few, and potential cover-up, do not effectively undermine the reputation of those working in maternity care across the whole country.

Cherilyn Mackrory: My hon. Friend is making brilliant points, which I am so grateful for. Does he agree that those healthcare professionals will probably welcome this because it will start to break down the blame culture that the hon. Member for North Ayrshire and Arran (Patricia Gibson) talked about?

Tim Loughton: My hon. Friend is absolutely right. We do not want a blame game. When I was the Minister for Children and we reviewed extraordinary and harrowing child deaths at the hands of various people, it was the blame game for social workers that so undermined the profession. It is not social workers who kill children; it is carers and others with evil intent. But where there has been incompetence, where the system has perhaps contributed to that incompetence or has effectively obstructed a professional from getting on with their job in the way that they would like to and can do, that is where we need the findings. In some cases, that may require a coronial investigation, which can look under every stone and really get down to the roots of the problems, rather than just point a finger of blame with which the whole profession gets tarred.
That is why—you will be relieved to hear, Madam Deputy Speaker, that I am about to end—my Bill, if I do say so myself, brought in some important and necessary changes in the law, most of which have happened, have been welcomed and have gone very well. This change was widely welcomed, but has not been enacted, and the need for it to be enacted has never been greater.
Back in 2019, ahead of the December election, I had promised couples that the regulations to allow civil partnerships would be brought in before the end of the   year. On the last day before Parliament was dissolved, those regulations were brought to the Floor of the House, and I had to move them—that would normally be done in Committee—in order to get them through in time with the help of the Chief whip. I do not want to have to do the same at the very last breath just ahead of the 2024 election, because there is no excuse for this not having happened several years ago.
I plead with the Minister. She supports these changes. The Government support these changes. This Parliament—both Houses—supports these changes. Parents, professionals and coroners support these changes. Why is she not getting on with bringing them in? Please, please, please knock heads together across both Departments and get these regulations laid, get the consultation results published, and let us bring in an additional layer of safety for parents who go through the trauma of stillbirth and have unanswered questions when they leave hospital without the child that they had hoped they would leave with.

Cherilyn Mackrory: It is a great honour to follow my hon. Friend the Member for East Worthing and Shoreham (Tim Loughton), who set out very clearly his work in this space, for which I am very grateful. I extend an offer to him to use the all-party parliamentary group on baby loss for anything that we can do to help bring about the conclusion that he requires, because I believe he is absolutely right.
I am incredibly grateful to my APPG co-chair, the hon. Member for North Shropshire (Helen Morgan), for requesting this debate and to the Backbench Business Committee for allowing it today. As my hon. Friend the Member for East Worthing and Shoreham has already said, it is now a tradition in this place to set aside time to discuss Baby Loss Awareness Week. I have had the privilege of chairing the APPG on baby loss for the last three years, and I also chair the all-party parliamentary group on women's health, which means that much of my time in this place is taken up with supporting women and families through some truly uncomfortable and sometimes deeply unpleasant experiences.
As colleagues may already be aware, Baby Loss Awareness Week was last week, when the House was in recess, but this debate is now marked in the calendar of this place. I know that many right hon. and hon. Friends are in other places today for many good reasons, but there is normally a lot of collaboration across the Benches. We forget party politics and talk about what is important. This debate should be a tradition in this place because it shows Parliament at its best. Not only does it allow the general public to remember that we are all human, but it also means that tribal party politics is put aside, allowing us to try to work together on these important issues.
I want to place on the record my sincere thanks to the APPG for the work that it did before my time in this place under the guidance of my right hon. and learned Friend the Member for Banbury (Victoria Prentis), now the Attorney General, and my hon. Friend the Member for Colchester (Will Quince). Both of them gave powerful testimonies in this place before I arrived. I also thank my former co-chair on the APPG, now Chancellor of the Exchequer, my right hon. Friend the Member for  South West Surrey (Jeremy Hunt), who has such a passion for this topic from his time as Health Secretary. It is through his actions that we are now seeing the NHS workforce plan come to fruition. It was a deeply held passion of his, and it is the key to unlocking a lot of what we talk about in this space.
The APPG, again before my time, established the national bereavement care pathway to improve bereavement care and reduce variabilities throughout the country. It has been adopted by the majority of trusts, but it is a constant challenge to ensure that it is maintained given all the competing priorities facing the NHS. I ask the local health leaders watching the debate today to please understand how important the pathway is. We have had two debates in the Chamber this afternoon on topics that affect so many women and so many families. I ask local health leaders not to put the pathway to one side because it could be a cost-saving exercise in their trust.
I also thank colleagues on both sides of the House who have in the past taken the time to remember the babies that have sadly been lost. I am approached day after day by people who work in this place—some of whom Members would never guess—who have told me privately that this happened to them decades ago and that they still cannot bring themselves to talk about it. We are left to be the advocates for everybody, and if we dug deep, everybody would know somebody who has suffered the loss of a baby or one very close to them.
I am really grateful for the local support in my community. I want to give a big thank you to Mike Spicer and the team at A&P in the port of Falmouth for lighting up their crane in pink and blue last week for Baby Loss Awareness Week. I also thank Nick Simmonds-Screech and the team at Costain who lit up one of the bridges over the A30 in pink and blue during the dualling works. It means a huge amount, and they did it as a favour to me, but all the Cornish families who have lost a baby will have seen those two monuments lit up. It just shows that we are thinking about them.
As I said, Baby Loss Awareness Week was last week, and at the local service in Truro I met the team from the Royal Cornwall Hospitals NHS Trust, including the bereavement midwives. Karen Stoyles, our chief nurse, was sadly absent with covid. I put on record my thanks to Kim O’Keeffe for all her work. We also met parents and families, and marked the occasion with the traditional wave of light, when people across the country who have lost a baby, or people who want to remember those who have lost a baby, light a candle at 7 pm and share the photographs. It means a lot, and that is why I wanted to get all that on the record so that we do not lose momentum in this space.
In my constituency of Truro and Falmouth, we are building a brand-new women and children's hospital. The principle behind the hospital is to deliver a holistic service to families in Cornwall, whether through sexual health or reproductive health advice or care throughout their pregnancy or the aftercare that mothers desperately need. When the hospital is finished in the next couple of years, my constituents will have on their doorstep a facility that specialises in a range of women’s health concerns. I hope it will be a sanctuary for women’s health and a place that really delivers a social benefit, leading to a tangible reduction in baby loss risk throughout  the south-west. It will include projects such as e-records, digital wards and, hopefully, electronic bed management. That all sounds very technical, but it frees up clinical staff to be clinical and to be at the bedside caring for patients.
My experience of chairing the two APPGs has confirmed to me that the Government do take baby loss incredibly seriously. We also owe thanks to charities such as Tommy’s, Sands and the Lullaby Trust for all their work in this field. They have incredible teams that do some of the best work, and I will always be grateful for everything they do to help me in this journey. It is also appropriate for me to thank the Minister for her efforts in keeping this at the top of the Department’s priority list, and I appreciate her for addressing the Sands and Tommy’s joint report launch in Portcullis House earlier this year.
It is very easy for our deliberations in this place to concentrate on, and constantly revert to, complaints about staffing levels. Although staffing is vital, it is prudent for us to focus on the core issues of quality practice and the information provided to parents throughout pregnancy. That is why I always go on about the continuity of care. We mentioned in the previous debate how that can help with baby loss in so many ways, and it has been proven to work in hospital trusts in areas where there is a greater chance of social deprivation. As soon as we can get staffing levels up to a safe standard, that continuity of care should be rolled out across the country. It picks up not only on lifestyle issues that could harm a baby, but on things such as domestic violence, which my hon. Friend the Member for East Worthing and Shoreham mentioned a moment ago, and so many other issues that can contribute to the preventable loss of a baby, particularly at full term. I cannot stress enough how important that is, and I will keep going on about it until we start to make progress.
I will quickly touch on support for parents after the event and the additional mental health support that we could provide. Mums and dads experiencing the loss of their baby will go through the worst time of their life, and everybody will have their own way of processing the grief. Some people will never get closure on it. As my APPG co-chair the hon. Member for North Shropshire mentioned, at our last meeting we listened to experts in the field of postnatal pathology and highlighted the recruitment and waiting-list issues that have been holding some families back from the closure that they deserve.
In an inquiry that we held a couple of years ago, it struck me that a baby born in Northern Ireland has to be taken to Alder Hey Hospital in Liverpool for a post-mortem—I think that is still the case—and it can take months and months before parents get their baby back. Some couples wait nearly a year. I think the same may apply to the Isle of Wight, but do not quote me on that. Certainly, different parts of the country have different set-ups. In Cornwall, our babies go as far as Bristol, and at the moment, the wait time for a post-mortem is weeks rather than months, but, given the stories I hear from around the country, it is a postcode lottery that we need to address urgently.

Helen Morgan: I want to re-emphasise that point because it is so important. When a baby goes for a post-mortem examination, it is in transit and away from its parents. The parents are often unable to keep track of the remains of their baby and when they will get  them back. Does the hon. Lady agree that we need to beef up that whole process to give parents the support that they need at such a difficult time?

Cherilyn Mackrory: I agree wholeheartedly. There are a couple of ways in which we can do that. One is the roll-out and expansion to all centres of minimally invasive autopsies and other non-invasive techniques. Not all post-mortems need to be invasive. Certainly, there needs to be an expansion of placental autopsies—if that is the right phrase—because the cause can often be found that way without the need to keep the baby for an awfully long time. We can do a lot more work in that space. The pathologists we have spoken to all want that work to be done, and if they had more time, they would be able to do more research on why it happens. At the moment, a baby could be lost at 38 or 40 weeks for absolutely no reason at all, and the parents will never find out why. Blame can be thrown around for the different things that happened on the day of the birth, but we just do not know the reason, and that is not acceptable in 2023. We will never find out every reason for every lost baby, but we could do an awful lot better.
I am told by Sands, the baby loss charity, that the shortage of perinatal pathologists has been growing over decades, and in recent years, mutual aid between pathology centres has reduced the impact on the national delivery of services, but that approach is breaking down as the capacity of overburdened centres to pick up cases beyond their own areas is dwindling. I cannot see that getting better without direct help in the near future.
We also need to get the basics right. The Royal Cornwall Hospital in Truro has the Daisy suite, which is a separate bereavement suite of rooms for those who lose their babies. It has its own bathroom and kitchen—not to put too fine a point on it, but being in labour puts extra pressure on your bowels and bladder, and you can be sick a lot. Being in that space is better not only to face the trauma, but because you do not have to see other parents holding their live babies. That was not available when I was going through the process of losing our baby. There was a girl there by herself—a young mum—who was 38 weeks pregnant when her baby had just stopped moving. Suddenly, I felt very well supported because I had someone there with me. Although we had a room to ourselves, I had to troop and up down the corridor to the bathroom, and I saw healthy babies, pregnant women who were glowing, and families who were just looking forward to taking their babies home. That is just too much to process, so I would be very grateful if we could avoid that. I was surprised to hear this week that the Snowdrop unit at Derriford Hospital has only just opened, but I am so pleased that parents in Plymouth can now make use of it at a time when they will be at their lowest.
This week, a colleague mentioned a constituent of hers who had delivered a stillborn baby and was left on a normal maternity ward—that is unacceptable. The woman was cradling her stillborn baby and people would walk past and congratulate her on the birth because they had no idea that her baby was not alive. She did not know what to say, so she just sort of nodded. Why, oh why, was that poor woman left in that vulnerable state? Most bereavement suites are funded with charitable donations, perhaps with some departmental funding. We need to get the basics right and in place. Although we cannot get everything right quickly, we can easily make things better.
The Royal College of Midwives “State of Maternity Services 2023” report sets out stark staffing shortages in some parts of the country. It acknowledges, however, that the number of people enrolling on maternity courses is up since 2019. Like me, the RCM supports the degree apprenticeship route, and it was fun to see its chief executive talk to a room of midwives who were quite cynical about degree apprenticeships. She was waxing lyrical about how much apprentices loved them, about how much experience they were getting on the ward, and about how they come out of it debt-free and with bags of experience.
What I found interesting is that that is a great way to keep experienced midwives on the ward. At the moment, a lot of them are suffering burnout, which is why staffing levels are leaking most starkly. A midwife in her 50s might have had enough, but if we offer them the chance to come back on the ward for three or four shifts a week to help train up new midwives, through live births and with practical help, they can do that at their own pace, and we would not lose all that experience all at once, so I am a huge advocate of the degree apprenticeship route.
Cornwall has started doing that. As I mentioned in the previous debate, Kim O’Keefe, chief nursing officer at the Royal Cornwall Hospitals NHS Trust, told me in the summer that we now have no midwifery vacancies in Cornwall. Not only has every single vacancy been filled but—this is unusual in this country—in Cornwall we have a waiting list of people who want to become midwives. That is testament to the work that the team there has been doing. Notwithstanding the fact that they are currently doing it in a decaying building while they wait with bated breath for our new women and children’s hospital, that all plays into better outcomes for parents and babies in Cornwall in the years to come.
There is so much to do in this space and so much more that I could say. We have not even spoken at length about dads, but a passion of mine is ensuring that dads are looked after during and after the loss of a baby. I do not want to get too personal about it without my husband’s consent, but it was very difficult for him to meet his baby. That is a personal choice. He was never offered any counselling at all. Being a fisherman, he just went out to sea. He has dealt with it in his own way. My advice to any couple watching this debate who has recently lost a baby is: please, please, please rely on other people outside your relationship—rely on family members, rely on your friendship circle—because although you will come back together, you cannot always grieve at the same time and at the same pace. A few moments ago I gave my hon. Friend the Member for East Worthing and Shoreham the statistic that 50% of relationships break down. That is because couples want to rely on the person who has always been there for them, but that person is suffering just as much and cannot always be there.

Sharon Hodgson: I did not mean to interrupt the hon. Lady. I am so grateful to her for giving way. Before she ends, I just want to commend her on picking up the mantle as one of the chairs of the all-party group on baby loss. I was one of the founding members, along with the right hon. and learned Member for Banbury (Victoria Prentis), the right hon. Member for Chichester (Gillian Keegan) and the former Member for Eddisbury, Antoinette  Sandbach. We all got together as parents who had been through baby loss and set up the all-party group. I am not as involved now as I would like to be, but I commend the hon. Member for Truro and Falmouth (Cherilyn Mackrory) for her energy and enthusiasm in keeping it going.
While I am on my feet, I have to commend the hon. Member for East Worthing and Shoreham (Tim Loughton) for his absolute, total commitment and drive for the last six-plus years in trying to get all elements of his private Member’s Bill through the House—those that have been passed by the House but are still not fully through. I disclosed my baby loss in the debate on his private Member’s Bill in 2017. I lost my baby 25 years ago, but the first time I talked about it really outside my immediate family was in 2017—I know the hon. Lady mentioned that point. I commend him, and I honestly hope that when the Minister responds we will get some good news on some of those final measures.

Cherilyn Mackrory: I am really grateful to the hon. Lady for sharing that with me. I apologise; I knew there would be so many Members I missed off my list. It is an open thank you to everybody who set up that APPG. I also did not mention the hon. Member for North Ayrshire and Arran (Patricia Gibson), who is here every year for the baby loss awareness debate and constantly reminds us of her loss. Baby Loss Awareness Week is not easy. We do it because we want to help other people, but it always brings it back. It was very raw for me on Sunday at the service in Truro and also for my mum. I pay tribute to everybody who works in this space. As I said in the previous debate to my hon. Friend the Member for Stafford (Theo Clarke), who is new on this journey, you have to look after yourself so that you can look after other people.
I will conclude. There is so much we can do here. I am glad the Minister is listening—she always is—and I look forward to working with her and anybody else who wants to, because we have to get it right for everybody, everywhere.

Patricia Gibson: I thank the hon. Member for North Shropshire (Helen Morgan) for bringing forward this debate, which has become something of an annual event in the calendar. It is very important that we have it.
I want to let the hon. Member for East Worthing and Shoreham (Tim Loughton) know that I agree with everything he said. In terms of coroner inquiries for stillbirths at full term, in Scotland we have fatal accident inquiries. Although it is devolved, it was one of the calls I made when I secured the first ever debate on stillbirth in this place in 2016. There is still a job of work to do to get us to where we want to be in that regard.
I always want to participate in this debate every year because I think it is an important moment—a very difficult moment, but an important one—in the parliamentary calendar. It is significant that the theme this year is the implementation of the findings of the Ockenden report in Britain, because that report was very important. We all remember concerns raised in the past about neonatal services in East Kent and Morecambe Bay, and the  focus today on the work undertaken by Donna Ockenden in her maternity review into the care provided by Shrewsbury and Telford Hospital NHS Trust really matters.
Donna Ockenden is currently conducting an investigation into maternity services at Nottingham University Hospitals NHS Trust. That comes in the wake of the fact that in the past, concerns have been raised about a further 21 NHS trusts in England with a mortality rate that is over 10% more than the average for that type of organisation, with higher than expected rates of stillbirth and neonatal death.
To be clear, I do not for one minute suggest that this is not a UK-wide problem, as I know to my personal cost. As the Minister will know, concerns remain that, despite a reduction in stillbirths across the UK, their number is still too high compared with many similar European countries, and there remain significant variations across the UK. Those variations are a concern. We know that they could be, and probably are, exacerbated by the socioeconomic wellbeing of communities. We know that inequality is linked to higher stillbirth rates and poorer outcomes for babies. Of course, the quality of local services is also a huge factor, and this must continue to command our attention.
When the Ockenden report was published earlier this year, it catalogued mistakes and failings compounded by cover-ups. At that time, I remember listening to parents on the news and hearing about what they had been through—the stillbirths they had borne, the destruction it had caused to their lives, the debilitating grief, the lack of answers and the dismissive attitude of those they had trusted to deliver their baby safely after the event. I do not want to again rehearse the nightmare experience I had of stillbirth, but when that report hit the media, every single word that those parents said brought it back to me. I had exactly the same experience when my son, baby Kenneth, was stillborn on 15 October 2009—ironically, Baby Loss Awareness Day.
That stillbirth happened for the same reasons that the parents described in the wake of the Ockenden report. Why are we still repeating the same mistakes again and again? I have a theory about that, which I will move on to in a moment. It was entirely down to poor care and failings and the dismissive attitude I experienced when I presented in clear distress and pain at my due date, suffering from a very extreme form of pre-eclampsia called HELLP syndrome. I remember all of it—particularly when I hear other parents speaking of very similar stories—as though it were yesterday, even though it is now 14 years later. I heard parents describing the same things that happened to me, and I am in despair that this continues to be the case. I hope it is not the case, but I fear that I will hear this again from other parents, because it is not improving. I alluded to that in my intervention on the hon. Member for East Worthing and Shoreham, and I will come back to it.
While I am on the issue of maternal health, expectant mothers are not being told that when they develop pre-eclampsia, which is often linked to stillbirths, that means they are automatically at greater risk of heart attacks and strokes. Nobody is telling them that they are exposed to this risk. I did not find out until about five years after I came out of hospital. Where is the support? Where is the long-term monitoring of these women? This is another issue I have started raising every year in the baby loss awareness debate. We are  talking about maternal care. We should be talking about long-term maternal care and monitoring the health of women who develop pre-eclampsia.

Steven Bonnar: My hon. Friend is making a very personal speech, and I am sure we are all listening intently. Will she join me in paying tribute to the wonderful charity that serves my constituency, Baby Loss Retreat, based in Glasgow? It is helping people through the most traumatic of times and making a real difference to families. Will she join me and that charity in calling on this place and the Government here to make available a register for certification for babies who are lost within 24 weeks of pregnancy? That has already been implemented by the Scottish Government, and it means so much to families who are coming to terms with such loss at a tragic time.

Patricia Gibson: I thank my hon. Friend for his intervention. I can see that the Minister was listening carefully, and I am sure she will want to take that back to her colleagues in Cabinet who can take the action that would allow parents who want a certificate before 24 weeks to have one. I also share his view about the importance of the charitable work that is done to support not only mums and dads but grannies and grandfathers when a stillbirth happens, providing them with the local, sensitive support that they need, because it is not always forthcoming from the NHS. When people try to regroup after this kind of loss, that ongoing support in the community is really important.
We are seeing too many maternity failings, and now deep concerns are being raised about Nottingham University Hospitals NHS Trust. I understand that the trust faces a criminal investigation into its maternity failings, so I will not say any more about it. The problem is that when failures happen—and this, for me, is the nub of the matter—as they did in my case at the Southern General in Glasgow, now renamed the Queen Elizabeth University Hospital, lessons continue to be not just unlearned but actively shunned. I feel confident that I am speaking on behalf of so many parents who have gone through similar things when I say that there is active hostility towards questions raised about why the baby died. In my case, I was dismissed, then upon discharge attempts were made to ignore me. Then I was blamed; it was my fault, apparently, because I had missed the viewing of a video about a baby being born—so, obviously, it was my fault that my baby died.
It was then suggested that I had gone mad and what I said could not be relied upon because my memory was not clear. To be absolutely clear, I had not gone mad. I could not afford that luxury, because I was forced to recover and find out what happened to my son. I have witnessed so many other parents being put in that position. It is true that the mother is not always conscious after a stillbirth. Certainly in my case, there was a whole range of medical staff at all levels gathered around me, scratching their heads while my liver ruptured and I almost died alongside my baby. Indeed, my husband was told to say his goodbyes to me, because I was not expected to live. This level of denial, this evasion, this complete inability to admit and recognise that serious mistakes had been made that directly led to the death of my son and almost cost my own life—I know that is the  case, because I had to commission two independent reports when nobody in the NHS would help me—is not unusual. That is the problem. That kind of evasion and tactics are straight out of the NHS playbook wherever it happens in the UK, and it is truly awful.
I understand that health boards and health trusts want to cover their backs when things go wrong, but if that is the primary focus—sadly, it appears to be—where is the learning? Perhaps that is why the stillbirth of so many babies could be prevented. If mistakes cannot be admitted when they are made, how can anyone learn from them? I have heard people say in this Chamber today that we do not want to play a blame game. Nobody wants to play a blame game, but everybody is entitled to accountability, and that is what is lacking. We should not need independent reviews. Health boards should be able to look at their practices and procedures, and themselves admit what went wrong. It should not require a third party. Mothers deserve better, fathers deserve better, and our babies certainly deserve better.
Every time I hear of a maternity provision scandal that has led to stillbirths—sadly, I hear it too often—my heart breaks all over again. I know exactly what those parents are facing, continue to face, and must live with for the rest of their lives—a baby stillborn, a much-longed-for child lost, whose stillbirth was entirely preventable.

Cherilyn Mackrory: I am really grateful to the hon. Lady for the testimony she is giving, and I absolutely agree with almost everything she is saying. However, does she agree that there is a very big difference between a genuine mistake that a midwife or health professional might make and negligence, and does she think we need to get better at differentiating those two things, so that healthcare professionals are not afraid to come forward and give the right information when an investigation takes place?

Patricia Gibson: I absolutely agree with the hon. Lady. The frustration, and the piling of trauma on tragedy, comes from the inability to engage at any level when things go wrong. Everybody knows that things can go wrong. People are human and they will make mistakes. It is what happens afterwards that matters. That is what matters to bereaved parents.
Some people talk about workforce pressure, and it has been mentioned today. However, to go back to the point made by the hon. Member for Truro and Falmouth (Cherilyn Mackrory), for me and, I think, many of the parents who have gone through this, the fundamental problem is the wilful refusal to admit when mistakes have happened and to identify what lessons can be learned in order to prevent something similar happening again. To seek to evade responsibility, to make parents feel that the stillbirth of their child is somehow their own fault or, even worse, that everyone should just move on and get on with their lives after the event because these things happen—that is how I was treated, and I know from the testimony I have heard from other parents that that is how parents are often treated—compounds grief that already threatens to overwhelm those affected by such a tragedy. I do not want to hear of another health board or NHS trust that has been found following an independent investigation to have failed parents and babies promising to learn lessons. Those are just words.
When expectant mums present at hospitals, they should be listened to, not made to feel that they are in the way or do not matter. How hospitals engage with parents during pregnancy and after tragedy really matters. I have been banging on about this since I secured my first debate about stillbirth in 2016, and I will not stop banging on about it. I am fearful that things will never truly change in the way that they need to, and that simply piles agony on top of tragedy. I thank Donna Ockenden for her important work, and I know she will continue to be assiduous in these matters in relation to other work that she is currently undertaking, but the health boards and health trusts need to be much more transparent and open with parents when mistakes happen. For all the recommendations of the Ockenden report—there are many, and they are all important—we will continue to see preventable stillbirths unless the culture of cover-ups is ended. When the tragedy of stillbirth strikes, parents need to know why it happened and how it can be prevented from happening again. That is all; a baby cannot be brought back to life, but parents can be given those kinds of reassurances and answers. That is really important to moving on and looking to some kind of future.
It upsets me to say this, but I have absolutely no confidence that lessons were learned in my case, and I know that many parents feel exactly the same. However, I am very pleased to participate again in this annual debate, because these things need to be said, and they need to keep being said until health boards and NHS trusts stop covering up mistakes and have honest conversations when tragedies happen, as sometimes they will. Parents who are bereaved do not want to litigate; they want answers. It is time that NHS trusts and health boards were big enough, smart enough and sensitive enough to understand that. Until mistakes stop being covered up, babies will continue to die, because failures that lead to tragedies will not be remedied or addressed. That is the true scandal of stillbirth, and it is one of the many reasons why Baby Loss Awareness Week is so very important, to shine a light on these awful, preventable deaths for which no one seems to want to be held accountable.

Eleanor Laing: I call the shadow Minister.

Abena Oppong-Asare: I congratulate the hon. Member for North Shropshire (Helen Morgan) and my hon. Friend the Member for Sheffield, Hallam (Olivia Blake) on securing this important Back-Bench debate to discuss Baby Loss Awareness Week. I thank all those who have spoken today on this important topic, including the hon. Members for East Worthing and Shoreham (Tim Loughton) and for Truro and Falmouth (Cherilyn Mackrory). I also take the opportunity to pay tribute to my hon. Friend the Member for Luton North (Sarah Owen), who has done a lot of work in this area and has shared her personal story of child miscarriage, and to my hon. Friend the Member for Sheffield, Hallam, who has been campaigning for over three years with Myleene Klass to secure changes. My hon. Friend is pleased that the Government have responded positively to the issues they have been campaigning on, which includes a trial of a graded model for sporadic and recurrent miscarriage care at Tommy’s in Birmingham.
I also pay tribute to members of the Baby Loss Awareness Alliance, including Sands, and all the charities involved in that work. They work together to drive through change and improvements in policy, research and bereavement care, and it is because of their great work that Baby Loss Awareness Week is such a great success each year. Furthermore, it is important to highlight the instrumental work of the all-party parliamentary group on baby loss. I applaud its work in supporting the establishment of the national bereavement care pathway, and its promotion of this debate and of Baby Loss Awareness Week in Parliament.
As Members may know, I am new to my role as the shadow Minister for women’s health and mental health. As such, I want to begin by sharing my deepest sympathies with all parents who have suffered the worst tragedy possible: the loss of their child. It is a privilege to have this opportunity to speak out, raise awareness and support change. Members may know a friend, loved one or constituent who has faced this terrible ordeal, and there is no more devastating experience. That is why this debate is so important. As previous speakers have highlighted, we must continue to stand up and champion the cause of Baby Loss Awareness Week to support families dealing with the grief of baby loss and to prevent it from happening in the first place. However, I want Members to know that, although I am new to this role, like so many I have long been an advocate of tackling the persistent issues that mothers in the UK face.
Constituents have shared with me their personal stories about their loss and the difficult grieving process that follows. I thank them all for sharing their stories to incentivise change. One constituent who lost her daughter said to me:
“My daughter matters. They all do.”
I want to share: “You are remembered, and you are missed.”
When it comes to the rate of mortality, it is good to know that levels have continually decreased in the last few decades. However, we will all be concerned that the rate of this decrease has slowed over recent years. Overall, the Government have set an ambition to halve the 2010 stillbirth rate in England by 2025. To meet this target, the rate would need to decrease to 2.6 per 1,000 births. Instead, last year the stillbirth rate for England was 3.9 per 1,000 births, so it will be important to hear from the Minister about her plans to accelerate our progress towards this target.
We also know that there remain significant geographical, racial and socioeconomic inequalities in these rates. For example, a few years ago NHS England reported that there was still a variation of about 25% in stillbirth rates across England. Office for National Statistics figures indicate that this geographical inequality persists. To be exact, the 2021 stillbirth rate for the 10% most deprived areas of England was more than twice as high as the rate in the 10% least deprived areas. That is 5.6 stillbirths per 1,000 births in the most deprived areas compared with 2.7 per 1,000 births in the least deprived. As Members would expect, the same shocking disparities occur in the neonatal mortality rate and the infant mortality rate.
Important work by groups already mentioned, such as Five X More, have highlighted that stillbirth rates for black babies are twice as high as for white babies, and  neonatal death rates are 45% higher. It is therefore clear that there is still so much more work to be done in this area, and I urge the Government to address these inequalities and the calls for changes and improvements to the system. We must accelerate this decline in the rates and tackle the appalling health inequalities that our country faces.
As well as tackling that, we must commit to supporting parents and families as they face the difficult process of grieving. All families affected by baby loss must receive the best care and support as soon as possible. We know that the sooner they get it, the better that care is for them, yet access to bereavement support varies across the country. Although most NHS trusts in England have joined the national bereavement care pathway, Ministers should do everything possible to improve provision.
There has also been a longstanding campaign by Sands for access to well-resourced continuity of carer models to ensure consistency in the midwife or clinical team. That would provide care for a mother and baby throughout the maternity journey. However, the Government have dropped the target for most women to have access to continuity of care. Furthermore, severe staffing shortages mean women can no longer expect to see the same midwife from scan to delivery. On top of that, the Government have rejected the Women and Equalities Committee recommendation to set a target and strategy to end disparities in maternal deaths. The pace of progress in enhancing maternity services has been frustratingly slow. They must set clear targets to address inequalities in maternal and neonatal outcomes. By doing that, they could ensure the delivery of safe care to all mothers and their babies.
The Opposition welcome the long-awaited NHS workforce plan, which mirrors the commitment we have been calling for, and the next Labour Government will deliver on those aims. Alongside that, we will reform the NHS so that it is there for people when they need it. We want our NHS back on its feet and fit for the future. I therefore look forward to hearing from the Minister about what work she has been doing with the NHS, charities and all those campaigning for change, and I also look forward to hearing what the Department has been and will be doing to reduce baby loss and support those grieving.

Maria Caulfield: I start by thanking the hon. Members for North Shropshire (Helen Morgan) and for Sheffield, Hallam (Olivia Blake). I know the hon. Member for Sheffield, Hallam could not be here this afternoon, but she has done a huge amount of work over the last 12 months, since the last debate. I also thank my hon. Friend the Member for Truro and Falmouth (Cherilyn Mackrory), who is the co-chair. This is a fantastic example of cross-party working on such an important issue to women, but also to men, up and down the country. I pay tribute to the work that those on the all-party parliamentary group do. They are tireless campaigners for improving support for all families who go through the heartbreak of losing a baby.
This is the 21st Baby Loss Awareness Week and the eighth consecutive year that this House has held a debate to mark it. I am proud, once again, to be able to applaud all campaigners, charities and clinicians who  mark Baby Loss Awareness Week. I will use my time this afternoon to provide an update on the progress we have made since the debate last year and on pregnancy loss in particular.
Before I do, I want to touch on the comments by my hon. Friend the Member for East Worthing and Shoreham (Tim Loughton), who is my constituency neighbour as well. I want to apologise because, while we have delivered most of the changes in his Act, we still have not published the consultation on coronial investigations into stillbirths. I know from speaking to Bill Kirkup and Donna Ockenden that they are very supportive of coronial investigations into stillbirths. I have met many parents who have suffered the horrendous experience of losing a baby and who are very supportive of this change. I was hoping to come to the Dispatch Box and be able to make a positive announcement. Unfortunately, I cannot do so this afternoon, but I can assure him that I will personally follow this up after the debate. I hope that, in a very short period of time, we will be able to make a positive announcement for him.
The loss of a baby is, tragically, a common outcome. We are improving rates. Stillbirth rates have reduced by 23% and neonatal mortality rates for babies born over 24 weeks’ gestation have reduced by 30%, but that is no consolation to those parents who experience baby loss when it does happen. We know that, too often, when baby loss occurs, the experience of parents and families is not what it should be. That is why the independent pregnancy loss review published its report in July, and the Government are supporting the recommendations in that report to make sure that every trust offers a consistent, compassionate service. The review made it clear that baby loss is too often treated as a clinical event, with emotional support failing or falling short in a number of areas. That is why it is so important that we reintroduce compassion as an element throughout the experience.
Let me take one example that was shown in the pregnancy loss review. I was horrified to read stories of women miscarrying at home and storing their baby’s remains in their fridge in a Tupperware container because they were waiting days for their early pregnancy loss unit to reopen. The review put it down in black and white that major improvements are needed and that is why we are supporting the recommendations.
The review made 73 recommendations for change within the NHS and wider society, and we have already started action on many of those. The first was touched on by the SNP spokesperson, the hon. Member for North Ayrshire and Arran (Patricia Gibson): the use of baby loss certificates for babies who are born before 24 weeks, who currently cannot be registered. We announced in July that we would be rolling out baby loss certificates. They will be retrospective. There is no time limit on applying for them.[Official Report, 7 November 2023, Vol. 740, c. 1MC.] They will be voluntary, so parents do not have to apply for one if they do not feel that they wish to. We are going through service user testing with families to ensure that the system we set up works for them. Following testing, there has been some service specification that we need to improve to ensure that the process runs smoothly. It will be run on the gov.uk website. Once we have those safeguards in place for both parents to be able to register on a certificate, we will announce the roll-out date formally to this place. It is important that parents who want to acknowledge the loss of their baby before 24 weeks are able to do so.
We also looked at the sensitive disposal of a baby after pregnancy loss, many instances of which happen at home rather than in hospital or clinical settings. It is important that women have access to proper collection facilities, so we have taken on board the recommendation on creating a bespoke receptacle to ensure that foetal remains can be collected and stored with due dignity. To do that we have been engaging with charities, women and healthcare professionals and we aim to finalise a specification by February. We are also working with the Human Tissue Authority to review and update its guidelines by March next year. NHS England is also consulting on a clear pathway to ensure that women can always have access to cold storage in NHS facilities, too.
We have also heard from women about the difficulty they often experience in getting help during a miscarriage. In partnership with NHS England, we are exploring how 111 and ambulance services can block-book appointments with early pregnancy assessment units, so that women in need can be directed straight to them if necessary; rather than going to A&E or other healthcare professionals, they can go straight to those units, where care can be provided with dignity and privacy. The review also proposes introducing graded care for women who suffer one, two or more miscarriages; the shadow Minister touched on that issue. We have taken on board those recommendations because currently, women have to suffer three miscarriages often before they get help.
Tommy’s miscarriage centre at the women’s hospital in Birmingham has launched a three-month pilot of that graded model, so that after one miscarriage assessments can be delivered. I have been to the unit to see the amazing work it does and I am looking forward to its results. It will look at that graded model and be able to present to us the difference that that will make to women experiencing baby loss. That will help to prevent further pregnancy losses in future.
Another recommendation made by the pregnancy loss review concerns the fact that families are often forced to grieve in public spaces. I want to be clear about this. Very often, the pregnancy facilities are inadequate. My hon. Friend the Member for Truro and Falmouth talked about the Daisy centre that is available in her area; it was not available when she tragically had to go through her experience. In many places, clinics, units and buildings are not able to meet women’s needs. Therefore, NHS England is surveying pregnancy facilities and will report back by the spring to ensure we can invest in those facilities to improve the outcome and experience for women and their families. We also need to improve bereavement support for both women and their families. That is another key area we are looking at.
Members touched on the number of midwives there are. I am pleased that in Cornwall there is a waiting list for training but across England there has been an increase in the number of midwives: there are 14.2% more than in 2010. We are engaging in a number of routes into midwifery. We have the degree apprenticeship now but we also have the nurse conversion course, which is popular with nurses who perhaps want to work in midwifery instead of nursing. Those routes are not just getting more midwives into practice but retaining them. That is a key element to be able to deliver all the asks in the pregnancy loss review.
We are also looking at how we support people in the workplace. It is important that women and families who experience baby loss are able to take the time off that they need. As a first step, the Department has signed the miscarriage association pregnancy loss pledge and we encourage other organisations to do so.
We could cover a number of issues that were raised in the debate. I just want to be clear with the House about all the issues that have been raised. With the ongoing maternity inquiries, we have set up a national oversight board so that we can pull together all the recommendations and findings, whether from Donna Ockenden, Bill Kirkup or other inquiries that have happened in the past, and make sure that every single maternity unit across England is responding to them, whether they are relevant to their units’ experience or not. We want consistent, good maternity care across the board, whether that is the Birthrate Plus model for making sure there are more midwives on units, making sure the capital framework of the unit is able to help support women who lose their babies, or ensuring that the culture of change that Bill Kirkup touched on so much in his review is rolled out, so that women have a compassionate experience when they go through the devastating loss of a baby.
It is our duty to support families who experience the devastating loss of a baby, and this Government remain committed to implementing all the independent pregnancy loss review’s recommendations. At the debate next year, I hope that my hon. Friend the Member for East Worthing and Shoreham will have a more positive comment to make and we will have addressed his concerns in detail, but also that we will have taken a step forward on many of the issues raised today and on some of the work we have started with the pregnancy loss review.

Helen Morgan: I start by thanking the Minister. She has always engaged constructively and proactively with the all-party parliamentary group on baby loss, and I welcome her commitment to the pregnancy loss review and implementing its findings. It is clear that we still have some way to go, and I am sure that this time next year we will be asking for further updates on progress against the Ockenden review, but I thank her for her constructive approach.
On the contributions made by other Members, the hon. Member for East Worthing and Shoreham (Tim Loughton) made a good point highlighting not only the impact of baby loss on dads and the need to support them, but the wider issue of helping people who have lost their baby to understand why their baby died, whether that is perinatal pathology or getting a coroner’s inquest into what happened. That is so important, and I thank him for raising that issue.
The hon. Members for Truro and Falmouth (Cherilyn Mackrory) and for North Ayrshire and Arran (Patricia Gibson) shared their personal experiences, which were extremely powerful, and I am extremely grateful to them. They both highlighted important issues, such as the national bereavement care pathway and its roll- out, the importance of continuity of carer and the appropriateness of physical facilities to look after mums and dads who have just lost their baby. Finally, I want to touch on the culture of cover-up, which has come up in every review, and the importance of focusing not just on clinical professionals, but on management culture  going forward. In conclusion, I thank everybody who contributed. It has been a useful way to recognise Baby Loss Awareness Week.
Question put and agreed to.
Resolved,
That this House has considered Baby Loss Awareness Week.

Black History Month

Motion made, and Question proposed, That this House do now adjourn.—(Scott Mann.)

Abena Oppong-Asare: I begin by saying that I find myself in an unusual situation today, as I have participated in a number of debates—this is my third—and it has been great getting to know the Minister a bit better. I thank Mr Speaker for selecting this important Adjournment debate and ensuring that we can once again debate Black History Month during the month of October.
Black History Month is an extremely important annual event, but I strongly believe we should be talking about black history week in, week out, and not just once a year. The theme of this year’s Black History Month is “Saluting our sisters”. I begin my speech, as I have done in previous years, by highlighting and celebrating a number of black Britons who have been under-appreciated and under-recognised in our national discourse. These black Britons are great Britons, and we should celebrate them as such. Again, I pay tribute to Akyaaba Addai-Sebo, co-ordinator of special projects for the Greater London Council, who organised the first recognition of this month in 1987.
With this year’s theme, I would like to highlight the crucial role that black women have played in shaping history, inspiring change and building communities. I have previously mentioned Mary Prince, who was the first woman to present an anti-slavery petition to Parliament and the first black woman to write and publish an autobiography. A petition was proposed to place a statue of her outside the Museum of London Docklands. To this day, there has been no statue.
I also pay tribute to some of Health Service Journal’s top 50 black figures who are leading the way in English NHS and health policy. Karen Bonner, one of a handful of acute trust chief nurses in the NHS, has been described as getting a great deal of attention for her “tremendous leadership” and “inspirational talks”. She has worked with Prostate Cancer UK to raise awareness of the disease in the black community. One in four black men will get prostate cancer in their lifetime. Black men are more likely to get prostate cancer than any other men, who have a one-in-eight-chance. We do not know why black men are more likely to get prostate cancer, but it is one of the easiest cancers to treat if detected early. It is good practice to have early testing and screening.
Dr Jacqui Dyer is a director of Global Black Thrive and one of the key voices calling for the mental health system to recognise the different experiences of black, Asian and minority people. Yvonne Coghill assists organisations in working towards workforce race equality and is a special adviser to and board member of the NHS race and health observatory.
Marie Gabriel is one of the most experienced black NHS non-executives in the country. Dr Lade Smith, the president of the Royal College of Psychiatrists, is the first black woman to hold the role in the college’s 182-year history and only the fifth woman. I cannot mention all 50, but they are all inspiring. I suggest that everyone checks them out.
As well as paying tribute to under-acknowledged black Britons, I want to use the debate to highlight some of the inequalities that continue to affect black  people in this country, which the Government must do more to address. First, there is black maternal health. I pay tribute to Five X More and the Motherhood Group for their outstanding campaigning on that. I am sure the Minister agrees that they have done so much to bring it up the political agenda. Their work has highlighted the stark disparities in outcomes that black women face when giving birth in this country. Black women in the UK are four times more likely to die while pregnant, while giving birth or as new mothers than white women. I commend Sandra, the founder of the Motherhood Group, for hosting the first ever black maternal health conference in the UK with the aim of rebuilding trust between the community and service providers and exploring the role of racism, human rights and structural change and how to engage effectively with black mothers.
I also commend the founders of Five X More, Clo and Tinuke, who held a women’s health summit to drive change. I am sure that the Minister saw the publication last week of the MBRRACE mortality and morbidity confidential inquiries report, which shows that there has been no change in the shocking statistics. Labour is committed to tackling that by training more midwives and health visitors, incentivising continuity of care and improving course content on the presentation of illness and pain among different groups. We will ensure that the NHS is squarely focused on tackling this shocking disparity. Put simply, giving birth as a black woman is considerably riskier than for women of other ethnicities. The Government know that that inequality exists, and now is the time for action.
I turn to another issue that affects black women and girls: the lack of specialist training for police and other agencies supporting black women who are victims of domestic abuse. I play tribute to Sistah Space, a domestic abuse charity supporting women of African and Caribbean heritage. It set up a petition to introduce Valerie’s law, which is named in memory of Valerie Ford, who was murdered by her former partner in 2014, alongside their 22-month-old daughter. She had previously asked the police for help after he ex-partner threatened to burn down their house with her in it. It was recorded only as a threat to a property.
While that story is shocking, sadly, it is not uncommon. Too many black women do not get the support they need because the police are not trained to spot and deal appropriately with domestic violence in black communities. That includes things such as missing signs of domestic violence on black skin, and the lack of cultural knowledge about how threats can be communicated. We need mandatory specialist training for the police and others on all that and more. I hope the Government will seriously consider that as part of a renewed focus on violence against women and girls, given recent events. I have raised this issue a number of times in Parliament, and was successful in getting a former Minister to agree to a meeting, following a debate on support for black victims of domestic abuse on 28 March 2022. That meeting took place, and a number of agreed actions followed. I met the representatives of the petition recently, who sadly informed me that nothing has followed since. I would be grateful if the Minister committed today that she or one of her colleagues will take up this matter as soon as possible.

Jane Stevenson: The hon. Lady raises some incredibly important points. I have a large number of black constituents. What national efforts need to be made to achieve the things that she is setting out so clearly?

Abena Oppong-Asare: I thank the hon. Lady for her intervention and for the water. The Government can do a number of things, which I will come to.
I would like to bring the House’s attention to the largest ever survey undertaken for black Britons, carried out recently by The Voice newspaper and Cambridge University. I hosted the publication of the “Black British Voices” report in Parliament. The data I saw was shocking but not surprising. It showed that people had serious concerns about racism across education and the workplace. The report revealed that 41% of more than 10,000 black Britons surveyed identified racism as the biggest barrier to young black people’s education attainment. Of those surveyed, 95% believed that the national curriculum neglects black lives and experience. I am sure that Members agree that those statistics are alarming. Furthermore, fewer than 2% believed that educational institutions take racism seriously. In the light of the data, more work needs to be done to address those issues. I am worried about young black people growing up feeling that the system does not really work for them, particularly when looking at opportunities that may arise.
I want to talk about the 75th anniversary of the Empire Windrush’s arrival in Britain, when half a million people came to the UK after the second world war. It is important to reflect on the shameful Windrush scandal and assess what progress the Government have made to right the wrongs they have perpetuated. I am proud to represent a diverse constituency and to champion the contributions of the Caribbean community, but the Government’s treatment of the Windrush generation is one of the most shameful episodes in our post-war history. The Windrush generation were victimised under the hostile environment policy. People have been let down by the compensation scheme that was not fit for purpose and betrayed by the Government not implementing all the recommendations of the Wendy Williams lessons learned report. I have raised that with the Government a number of times and I am disappointed that there has not been a huge amount of progress in addressing it. I am proud that Labour will help to deliver justice for the Windrush generation by looking to overhaul the Windrush scheme and putting it outside Home Office control, and enacting all the recommendations of the Wendy Williams review.
I want to return to the asks that I made of the Government during the Black History Month debate last year. The first was for action to diversify the curriculum. As I have said previously, I want our children, whether they are black or white, in every corner of the country, to better understand our national history and culture. That includes talking about the good and the bad—the range of experiences that people have had. I am pleased by the progress being made by the Welsh Government; Wales has become the first UK nation to make the teaching of black, Asian and minority ethnic histories and experiences mandatory in the school curriculum. I believe that black history is British history and needs to be taught all year round.
My second ask was for the implementation of a race equality strategy and action plan. There has been much discussion about the inequality and structural racism in our country. The Government have done some work, particularly in relation to the Sewell report, which was seen as controversial, but they have not always been seen to go far enough in terms of concrete action. A race equality strategy and action plan, which is desperately needed, would cover areas such as education, health and employment, and should include specific proposals to address well-known inequalities such as the ethnicity pay gap, unequal access to justice and the impacts of the pandemic on black people. I support the Labour party’s policy on that.
In the current climate, as we come to a general election, I do not want any political party to see certain ethnic minority groups as a tool in culture wars. We need to make sure in the run-up to the election that everyone plays a role and that no one feels that they are being targeted because of their ethnicity. I am grateful, once again, for the opportunity to speak in this debate.

Maria Caulfield: I am grateful to be able to contribute to this Adjournment debate to mark Black History Month. I congratulate the hon. Member for Erith and Thamesmead (Abena Oppong-Asare) on what has been a marathon afternoon for us both. It is lovely to finish the afternoon by responding to such an important debate.
As Minister for Women, I was pleased to see that one of this year’s themes for Black History Month is “celebrating sisters”. That gives us a chance to recognise the important contribution that black British women have made in the story of this nation. From individuals such as Mary Seacole, a trailblazing nurse who served during the Crimean war, to women from the Windrush generation who helped rebuild this country after the second world war, these pioneering women fought for civil rights and equality, playing an essential role in shaping the diverse and inclusive nation we are today.
As a Government, we are committed to ensuring that Black History Month is, as the hon. Lady said, not a once-a-year event and that schools are equipped to teach black history all year round. How our past is taught is crucial to ensuring that every pupil, regardless of their background, feels a sense of belonging to this country. We also want to celebrate the fact that our country is more diverse than ever before. According to the 2021 census, 18% of people in England and Wales are now from an ethnic minority group, compared with just 14% in 2011. Integration is also increasing, with the mixed- ethnicity population in England increasing by 40% in 10 years; 2.4 million households are now multi-ethnic.

Abena Oppong-Asare: According to some of the latest data, contained in a report produced recently by the newspaper the Voice in conjunction with Cambridge University, although we are seeing more diversity, especially in communities, there are concerns about the way people feel. May I urge the Minister to look at the report and think about what action can be taken in that regard?

Maria Caulfield: I have not seen the report, but I shall be happy to look at it, because the question of how people feel is important, in terms of both their experience and how it shapes their future.
It would of course be naive to say that tolerance and inclusion are the universal experiences of everyone who lives here, which is why, in July 2020, the then Prime Minister established the Commission on Race and Ethnic Disparities. We published our response to the Commission, “Inclusive Britain”, in March last year. That response sets out a groundbreaking action plan to level up the country, with three clear aims: to build a stronger sense of trust and fairness in our institutions—the hon. Lady touched on that, in relation to maternal health in particular —to promote equality of opportunity, encouraging aspiration and empowering individuals to reach their full potential; and to encourage and instil a sense of belonging to a multi-ethnic United Kingdom that celebrates its differences while embracing the values that unite us all.
The landmark “Inclusive Britain” strategy sets out 74 actions to tackle entrenched ethnic disparities in health, education, employment, policing and criminal justice. The strategy aims to increase trust and fairness, promote equality of opportunity, nurture agency, and foster a greater sense of belonging and inclusion. In April we published an update for Parliament, setting out the excellent progress we had made in delivering our ambitious strategy. This is a cross-Government approach, and we have delivered a number of changes already. There is new guidance from employers on how to use positive action in the workplace. We have published our ambitious schools White Paper, and provided targeted support for pupils who need it the most. We have established an Inclusion at Work panel to promote fairness in the workplace, and we are improving the stop and search process through new training for police officers. All of that will make a difference to the lives of black communities. Eighteen months on, we have already completed more than half those 74 actions, and we are proud to be delivering on our promises to all our citizens.

Abena Oppong-Asare: I appreciate that the Government are taking steps to try to address this issue, but given that this is the 75th year of the Windrush generation, I should like to hear more about what they are going to do for, in particular, those who have contributed so much to the NHS, have worked in Transport for London, and have helped our public sectors in general. They are being massively left behind, and the compensation scheme has not moved forward at all.

Maria Caulfield: The hon. Lady raised that point in her speech. We want to make sure that this is a fair scheme. The Home Office has reduced the time taken to allocate a claim for a substantive casework consideration from 18 months to less than five months. However, I fully understand the points that the hon. Lady has made, and I am happy to raise them with Home Office colleagues, because we fully understand the frustration and the upset that has been caused.

Abena Oppong-Asare: It is great that the case workload has been reduced, although it needs to be speeded up. However, I want to ask about the Wendy Williams review, which has been in place for some time. Is the Minister able to give us any firm commitments on its full implementation and any timescales applying to that?

Maria Caulfield: I am not able to give a firm commitment from the Dispatch Box this afternoon, but I can update the hon. Lady, and I shall be happy to write to her with some firm timelines after the debate.
I understand that Windrush is a particularly sensitive area, but I reassure the hon. Lady that we are making progress across the board, particularly on the school curriculum. Our model history curriculum will help pupils to understand the complex nature of British history and their place within it.
The hon. Lady touched on maternal health, and the evidence and statistics show that women from black, Asian and working-class backgrounds have poorer maternity outcomes, which is why I am so pleased that we set up the maternity disparities taskforce. My co-chair Wendy Olayiwola is a trailblazing black woman, and she follows the fantastic Professor Jacqueline Dunkley-Bent, who transformed how maternity services respond to black women in particular.
We established the taskforce in February 2022 to tackle disparities for mothers and babies, and our work is currently focused on pre-conception health and wellbeing because our understanding is that disparities are often bedded in by the time a woman is pregnant. The way to reduce those disparities is to ensure that women have help and support before getting pregnant, as that is the best way to ensure a safe outcome during pregnancy and birth.
The taskforce met in September, just a few weeks ago, and we are bringing together experts from across the health system, including some of the charities that the hon. Lady talked about, to explore and consider interventions. We are looking at setting up a pre-conception toolkit, and those charities, including Five X More, are feeding in what they think will make the greatest difference  for women across the board. We know from their testimony that previous poor experience of healthcare services often prevents black women from engaging with healthcare services in future. It is important that we break down those barriers and change black women’s experience of NHS services.
Our Online Safety Bill will soon become law, allowing us to hold social media companies to account in clamping down on online racist abuse. This is just a taste of the work we have done and will continue to do to make sure the inclusive Britain commitments are implemented.
The hon. Lady touched on a meeting back in 2022. I was not the Minister at the time, but I am happy to follow up and let her know the outcomes. If it has not been actioned since that meeting, I will follow it up.
I am grateful for the points raised by the hon. Lady throughout this debate. I share some of her concerns, particularly on maternity services, and we are committed to trying to transform the statistics to make sure that black and Asian women in particular, have better maternity outcomes.
Across the board, the Government are committed to continuing to work towards a society in which every individual, regardless of their background, has the opportunity to succeed. We are not there yet, as the hon. Lady so eloquently pointed out, but I have every confidence that the decisive action we are taking as part of our inclusive Britain strategy will help us to achieve that goal.
Question put and agreed to.
House adjourned.